Individual
JESSICA CHAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1824 S 11TH ST, BROKEN ARROW, OK 74012-5713
(918) 313-7830
Mailing address
1824 S 11TH ST, BROKEN ARROW, OK 74012-5713
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
02/14/2025
Last updated
02/14/2025
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