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Organization
TWENTY-NINE 11, INC.
Active
Organization
TWENTY-NINE 11, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JILL JANAE NEWMAN LPC (LICENSED PROFESSIONAL COUNSELOR)
(405) 401-5215
Entity
Organization
Contact information
Practice address
1605 N HARRISON ST, SHAWNEE, OK 74804-4022
(405) 765-3789
Mailing address
19501 S ROCK CREEK RD, SHAWNEE, OK 74801-9626
(405) 401-5215
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
5641
OK
Other
Enumeration date
10/18/2016
Last updated
10/18/2016
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