Individual
JACQUELINE F KIRSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA, MHPP,WC,RSS
Contact information
Practice address
711 S MUSKOGEE AVE, TAHLEQUAH, OK 74464-4717
(918) 207-0078
(918) 207-0058
Mailing address
711 S MUSKOGEE AVE, TAHLEQUAH, OK 74464-4717
(918) 207-0078
(918) 207-0558
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116378726
—
AR
05
—
1326243742
—
OK
Enumeration date
06/16/2007
Last updated
06/25/2021
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