Individual
JACI MASHBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2325 S HARVARD AVE, TULSA, OK 74114-3300
(918) 712-4301
Mailing address
7235 S 92ND EAST AVE APT 2, TULSA, OK 74133-5248
(405) 614-0754
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/25/2024
Last updated
01/25/2024
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