Individual
MR. JACOB AUSTIN SLAGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSBS
Contact information
Practice address
5007 SW COUNTRY CLUB DR, LAWTON, OK 73505-6830
(580) 591-1912
Mailing address
5007 SW COUNTRY CLUB DR, LAWTON, OK 73505-6830
(580) 591-1912
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
—
OK
106H00000X
Marriage & Family Therapist
Primary
—
OK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
02/25/2012
Last updated
08/08/2024
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