Individual
JENNIFER TRACEY MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
101 S MOORE AVE, CLAREMORE, OK 74017-5047
(918) 342-6460
Mailing address
523 W ROANOKE ST, BROKEN ARROW, OK 74011-2430
(918) 849-8384
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20155
OK
Other
Enumeration date
04/24/2024
Last updated
04/24/2024
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