Individual
JACLYN JOHNDROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC S
Contact information
Practice address
1608 E GRANGER ST, BROKEN ARROW, OK 74012-8311
(918) 381-5292
Mailing address
1608 E GRANGER ST, BROKEN ARROW, OK 74012-8311
(918) 381-5292
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5937
OK
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
05/21/2013
Last updated
03/11/2022
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