Individual
COLLISSA DEE JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
1018 E 9TH ST, OKMULGEE, OK 74447-5204
(918) 853-8400
Mailing address
1018 E 9TH ST, OKMULGEE, OK 74447-5204
(918) 853-8400
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200287120A
—
OK
Enumeration date
05/25/2013
Last updated
05/25/2013
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