Individual
JADE CHANTELLE BOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BHRS
Contact information
Practice address
1140 INDIGO RD, BROKEN BOW, OK 74728-5824
(580) 236-5335
Mailing address
1140 INDIGO RD, BROKEN BOW, OK 74728-5824
(580) 236-5335
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
BHRS
OK
Other
Enumeration date
10/31/2013
Last updated
10/31/2013
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