Individual
MRS. JESSICA L VASA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
101 N UNION AVE, SHAWNEE, OK 74801-7067
(405) 878-1135
(405) 878-1138
Mailing address
101 N UNION AVE, SHAWNEE, OK 74801-7067
(405) 878-1135
(405) 878-1138
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/07/2012
Last updated
11/22/2017
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