Individual
MANDY JEROME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
69 ARROWHEAD LOOP, CANADIAN, OK 74425-5012
(918) 339-5800
(918) 339-5833
Mailing address
69 ARROWHEAD LOOP, CANADIAN, OK 74425-5012
(918) 339-5800
(918) 339-5833
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/05/2017
Last updated
05/05/2017
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