Individual
MRS. JEANIE STAUB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
1175 S ASPEN, BROKEN ARROW, OK 74012
(479) 422-2190
Mailing address
10632 S MEMORIAL #120, TULSA, OK 74133
(479) 422-2190
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/03/2009
Last updated
02/03/2009
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