Individual
JESSICA STOMBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
808 S PEORIA AVE, TULSA, OK 74120-4427
(918) 560-1300
Mailing address
808 S PEORIA AVE, TULSA, OK 74120-4427
(918) 560-1300
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
5015
OK
Other
Enumeration date
04/24/2014
Last updated
10/10/2023
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