Individual
JESS MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
RR 1 BOX 7180, ANTLERS, OK 74523-9743
(580) 380-1557
Mailing address
PO BOX 265, ANTLERS, OK 74523-0265
(580) 380-1557
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
11/06/2013
Last updated
11/06/2013
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