Individual
JACKIE YORK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 S TREATY RD, MIAMI, OK 74354-5327
(918) 540-1511
(918) 542-7374
Mailing address
PO BOX 594, MIAMI, OK 74355-0594
(918) 541-5057
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/14/2011
Last updated
04/13/2015
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