Individual
MS. DEBRA ANN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
312 SE 5TH STREET, WILBURTON, OK 74578
(918) 465-3911
Mailing address
PO BOX 208, RED OAK, OK 74563-0208
(918) 465-3911
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
OK
Other
Enumeration date
04/30/2007
Last updated
07/08/2007
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