Individual
JESSICA LENA CALHOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
801 E MAIN ST, TISHOMINGO, OK 73460-2351
(580) 371-3776
Mailing address
409 E MAIN ST, WAPANUCKA, OK 73461-8101
(580) 230-7357
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/02/2013
Last updated
10/01/2013
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