Individual
JANA KATHLEEN REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW-P
Contact information
Practice address
905 NW 4TH ST, STIGLER, OK 74462-1652
(918) 630-6842
(918) 967-8203
Mailing address
905 NW 4TH ST, STIGLER, OK 74462-1652
(918) 630-6842
(918) 967-8203
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5148-P
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200418870A
—
OK
Enumeration date
01/23/2012
Last updated
06/05/2015
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