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1194459362
JACLYN NICHOLE PURNELL
TAHLEQUAH, OK
NPI
1194459362
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
Additional Taxonomies
251B00000X Case Management
Enumeration Date
2022-07-13
Last Update Date
2022-07-25
Business Address
JACLYN NICHOLE PURNELL
118 W KEETOOWAH ST
TAHLEQUAH, OK 74464-3820
Phone number: 918-708-2015
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Mailing Address
JACLYN NICHOLE PURNELL
909 LINN AVE
WAGONER, OK 74467-2132
Phone number: 405-220-7173
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