Individual
MRS. JAMEY LYNN VANDIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
601 S. 142TH ST. W., TAFT, OK 74463-0316
(918) 682-7841
Mailing address
608 S DAVID LN, MUSKOGEE, OK 74403-7711
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/11/2006
Last updated
04/19/2010
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