Individual
JESSICA WALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1622 N GREENWOOD AVE, TULSA, OK 74106-4319
(918) 584-0905
Mailing address
1622 N GREENWOOD AVE, TULSA, OK 74106-4319
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
J082239520
OK
Other
Enumeration date
04/08/2015
Last updated
04/08/2015
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