Individual
E JEANNETTE CONWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
17 S CENTRAL AVE, IDABEL, OK 74745-4625
(580) 286-5184
(580) 286-5185
Mailing address
406 NE 4TH ST, ANTLERS, OK 74523-3236
(580) 239-2228
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3487
OK
Other
Enumeration date
05/24/2007
Last updated
07/08/2007
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