Individual
MRS. TASHA LEE JANTZEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LADC
Contact information
Practice address
605 W OXFORD AVE, ENID, OK 73701-1208
(580) 977-7040
Mailing address
605 W OXFORD AVE, ENID, OK 73701-1208
(580) 977-7040
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
06/10/2008
Last updated
09/27/2011
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