Individual
JACQUELINE MARIE MCNUTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
90 N 31ST ST, CLINTON, OK 73601-9116
(580) 323-6021
(580) 323-0828
Mailing address
90 N 31ST ST, CLINTON, OK 73601-9116
(580) 323-6021
(580) 323-0828
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316152432
—
OK
Enumeration date
05/15/2017
Last updated
07/21/2022
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