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Individual

JANA STACEY EMERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1135 S YALE AVE, TULSA, OK 74112-5342
(918) 833-9815
Mailing address
1135 S YALE AVE, TULSA, OK 74112-5342
(918) 833-9815

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
10/13/2011
Last updated
10/13/2011
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