Individual
MRS. JILLIAN M EWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., LPC
Contact information
Practice address
198 E ALMAR DR, CHICKASHA, OK 73018-7327
(405) 222-5437
Mailing address
PO BOX 829, CHICKASHA, OK 73023-0829
(405) 222-5437
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200437530A
—
OK
Enumeration date
07/11/2012
Last updated
07/14/2022
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