Individual
MRS. JACQUELINE SHERRY WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BMHCC, IINHCC, BHCC,
Contact information
Practice address
5508 S LEWIS AVE STE 200, TULSA, OK 74105-7105
(918) 985-1129
Mailing address
5508 S LEWIS AVE STE 200, TULSA, OK 74105-7105
(918) 985-1129
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
3512610284
OK
171400000X
Health & Wellness Coach
Primary
3512610284
OK
Other
Enumeration date
06/05/2024
Last updated
06/05/2024
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