Individual
JESSICA BASHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
216 S MAIN ST, HOBART, OK 73651-3628
(405) 424-7711
Mailing address
602 W SPROAT ST, MANGUM, OK 73554-3827
(580) 480-2762
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/24/2025
Last updated
04/28/2025
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