Individual
JILL NEWMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
44038 45TH ST, SHAWNEE, OK 74804-9683
(405) 337-0055
(405) 584-4038
Mailing address
44038 45TH ST, SHAWNEE, OK 74804-9683
(405) 827-2514
(405) 584-4038
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200425100B
—
OK
Enumeration date
03/28/2012
Last updated
01/14/2022
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