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Organization

PAULETTE JOBE LCSW

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAETON PAULETTE JOBE LCSW (SOLE MEMBER)
(405) 772-7440
Entity
Organization

Contact information

Practice address
5480 MAIN STREET, SUITE 104, DEL CITY, OK 73115-9998
(405) 772-7440
(405) 601-7796
Mailing address
5480 MAIN STREET, SUITE 104, DEL CITY, OK 73115-9998
(405) 772-7440
(405) 601-7796

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3944
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200360040B
OK
Enumeration date
02/16/2015
Last updated
02/16/2015
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