Twenty-nine 11, Inc. | |
1605 N Harrison St Shawnee OK 74804-4022 | |
(405) 765-3789 | |
Not Available |
Full Name | Twenty-nine 11, Inc. |
---|---|
Speciality | Counselor |
Location | 1605 N Harrison St, Shawnee, Oklahoma |
Authorized Official Name and Position | Jill Janae Newman (LICENSED PROFESSIONAL COUNSELOR) |
Authorized Official Contact | 4054015215 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Twenty-nine 11, Inc. 19501 S Rock Creek Rd Shawnee OK 74801-9626 Ph: (405) 401-5215 | Twenty-nine 11, Inc. 1605 N Harrison St Shawnee OK 74804-4022 Ph: (405) 765-3789 |
NPI Number | 1235680984 |
---|---|
Provider Enumeration Date | 10/18/2016 |
Last Update Date | 10/18/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235680984 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | 5641 (Oklahoma) | Primary |
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› Verified 9 days ago
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