Individual
JAMIE WORSTELL WOHLETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1912 LAKE RD, PONCA CITY, OK 74604-4800
(580) 763-1902
Mailing address
1912 LAKE RD, PONCA CITY, OK 74604-4800
(580) 763-1902
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
10760
OK
Other
Enumeration date
10/23/2019
Last updated
01/04/2024
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