Individual
AMANDA JESSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
202 W 4TH ST, SKIATOOK, OK 74070-1409
(918) 408-8711
Mailing address
510 MAPLEWOOD LN, SKIATOOK, OK 74070-3813
(918) 480-8711
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPCCANDIDATE10273
OK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
08/14/2018
Last updated
01/27/2023
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