Individual
MS. JENNIFER MICHELE GAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
117 ROGERS DRIVE, HOLDENVILLE, OK 74848
(405) 379-6668
Mailing address
PO BOX 590, HOLDENVILLE, OK 74848-0590
(405) 379-6668
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/19/2010
Last updated
05/19/2010
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