Individual
MICHELLE IRENE ANGELIQUE JONAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1413 N LINCOLN AVE, MOORE, OK 73160-6517
(405) 760-5830
Mailing address
1413 N LINCOLN AVE, MOORE, OK 73160-6517
(405) 760-5830
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
22608
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22608
OKLAHOMA DEPARTMENT OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES BHCS LEVEL II
—
Enumeration date
06/19/2012
Last updated
06/19/2012
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