Individual
JACOB THOMAS CROWDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
21 S EIGHT TRIBES TRAIL SUITE B, MIAMI, OK 74354-5327
(918) 387-8720
Mailing address
828 C ST NW, MIAMI, OK 74354-4613
(918) 540-0975
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7583
OK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
03/07/2017
Last updated
01/20/2022
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