Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | ||
N | 175L00000X | Homeopath |
NPI | 1972139830 |
---|---|
Provider Name | Vanessa M Jones |
First Address | Guthrie, OK 73044-6656 |
Second Address | Guthrie, OK 73044-6656 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2020 |
Last Update Date | 22/03/2020 |