Individual
MR. JESSE DON PACHECO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.B.S., LPCS
Contact information
Practice address
4387 W BOGGY DEPOT RD, ATOKA, OK 74525-5472
(580) 387-9383
Mailing address
4387 W BOGGY DEPOT RD, ATOKA, OK 74525-5472
(580) 387-9383
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4063
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100699600C
—
OK
Enumeration date
01/10/2007
Last updated
08/16/2024
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