Individual
JESSICA K MORDECAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BHRS
Contact information
Practice address
628 E CREEK AVE, MCALESTER, OK 74501-6930
(918) 421-3500
(918) 423-2370
Mailing address
PO BOX 1404, MCALESTER, OK 74502-1404
(918) 421-3500
(918) 423-2370
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200049040
—
OK
Enumeration date
01/12/2012
Last updated
07/18/2013
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