Individual
JACQUE A GOWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
900 NE 10TH ST, OKLAHOMA CITY, OK 73104-5420
(405) 271-4311
Mailing address
900 NE 10TH ST, OKLAHOMA CITY, OK 73104-5420
(405) 271-4311
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
AP15-839
MN
1041C0700X
Clinical Social Worker
Primary
20118
OK
1041C0700X
Clinical Social Worker
25590
MN
1041C0700X
Clinical Social Worker
8964
WI
Other
Enumeration date
09/21/2015
Last updated
01/18/2024
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