Individual
JILL N DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11510 N 109TH AVE E, OWASSO, OK 74055
(918) 212-8703
Mailing address
11510 N 109TH AVE E, OWASSO, OK 74055
(918) 212-8703
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
OK
101YP2500X
Professional Counselor
Primary
—
OK
Other
Enumeration date
01/17/2025
Last updated
01/17/2025
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