Individual
GLENN JONES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
109 S HARRILL AVE, WAGONER, OK 74467-5317
(918) 892-2681
Mailing address
109 S HARRILL AVE, WAGONER, OK 74467-5317
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
03/07/2022
Last updated
08/08/2022
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