Individual
MS. MARY JACQUE ISHCOMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2000 E LINCOLN RD, IDABEL, OK 74745-7353
(580) 286-6639
(580) 286-5206
Mailing address
2000 E LINCOLN RD, IDABEL, OK 74745-7353
(580) 286-6639
(580) 286-5206
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/16/2007
Last updated
07/08/2007
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