Individual
SELENE JAQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
90 NORTH 31ST STREET, CLINTON, OK 73601
(580) 323-6021
(580) 323-9375
Mailing address
622 S 6TH ST, CLINTON, OK 73601-4616
(580) 515-0836
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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