JONATHAN BLAKE WHITE

POTEAU, OK
NPI1194151142
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2013-09-23
Last Update Date2013-09-23
Business Address
-- JONATHAN BLAKE WHITE
2706 N BROADWAY ST
POTEAU, OK 74953-5402
Phone number: 918-647-0485
Mailing Address
-- JONATHAN BLAKE WHITE
2706 N BROADWAY ST
POTEAU, OK 74953-5402
Phone number: 918-647-0485
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