Individual
JACQUELINE ELOISE EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
6216 S LEWIS AVE, TULSA, OK 74136-1044
(918) 960-7852
Mailing address
4916 S PITTSBURG AVE, TULSA, OK 74135-3110
(918) 812-4953
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8073-P
OK
Other
Enumeration date
09/09/2021
Last updated
09/09/2021
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