Individual
JESSICA WOMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
RR 4 BOX 139, BROKEN BOW, OK 74728-9467
(580) 584-2709
Mailing address
PO BOX 1383, BROKEN BOW, OK 74728-1383
(580) 584-2709
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/27/2009
Last updated
09/27/2009
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