Individual
JENNIFER JANOUSEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
405 E EXCELSIOR AVE, VINITA, OK 74301-4226
(918) 418-3107
Mailing address
405 E EXCELSIOR AVE, VINITA, OK 74301-4226
(918) 256-6476
(918) 256-3628
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6264
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306211578
—
OK
Enumeration date
12/14/2015
Last updated
04/17/2018
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