Individual
JONATHAN DAVID PIERCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
109 S HARRILL AVE, WAGONER, OK 74467-5317
(918) 485-3554
Mailing address
109 S HARRILL AVE, WAGONER, OK 74467-5317
(918) 485-3554
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CADC, US
OK
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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