Individual
MISS JACKIE RAE POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.W.
Contact information
Practice address
RR 1 BOX 131C, EUFAULA, OK 74432-9223
(918) 452-3133
Mailing address
RR 1 BOX 131C, EUFAULA, OK 74432-9223
(918) 452-3133
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/13/2011
Last updated
10/13/2011
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