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Individual

JACOB ALLEN DEWBERRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC-C

Contact information

Practice address
1728 S CARSON AVE, TULSA, OK 74119
(918) 574-8442
Mailing address
1728 S CARSON AVE, TULSA, OK 74119
(918) 574-8442

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
OK

Other

Enumeration date
02/12/2024
Last updated
03/04/2026
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