Individual
JESSENA SAMUEL VARGHESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9929 BIRKENHEAD CT, YUKON, OK 73099-7945
(718) 235-3100
Mailing address
9929 BIRKENHEAD CT, YUKON, OK 73099-7945
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
05/05/2015
Last updated
01/13/2018
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