Individual
JESSIE BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8204 NW 31ST TER, BETHANY, OK 73008-4348
(580) 458-0920
Mailing address
8204 NW 31ST TER, BETHANY, OK 73008-4348
(580) 458-0920
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/01/2015
Last updated
10/01/2015
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