Individual
JESSICA A HAWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
304 N BRISTOW AVE, COWETA, OK 74429-2106
(918) 289-6516
Mailing address
304 N BRISTOW AVE, COWETA, OK 74429-2106
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC07036
OK
Other
Enumeration date
12/14/2015
Last updated
05/03/2023
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