Individual
JONATHAN CARL WALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
1116 19TH ST, WOODWARD, OK 73801-2925
(580) 922-5656
(580) 922-3261
Mailing address
PO BOX 177, SEILING, OK 73663-0177
(580) 922-5656
(580) 922-3261
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20363
OK
Other
Enumeration date
09/08/2020
Last updated
10/21/2024
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