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1104049410
JON R PENOI
OKLAHOMA CITY, OK
NPI
1104049410
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OK 217)
Enumeration Date
2007-04-11
Last Update Date
2007-07-08
Business Address
-- JON R PENOI L.A.D.C.
425 NW 7TH ST
OKLAHOMA CITY, OK 73102-2810
Phone number: 405-235-9709
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Mailing Address
-- JON R PENOI L.A.D.C.
704 NEAL CIR
EL RENO, OK 73036-5620
Phone number: 405-235-9709
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