| Doctor Name: | JASON HEAD |
| NPI Number: | 1063614295 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 619 N Main St Muskogee, OK - 744014431 |
| Business Phone Number: | 9186822491 |
| Business Fax Number: | 9182682148 |
| Mailing Address: | 619 N Main St, MUSKOGEE |
| State: | OK |
| Postal Code: | 744014431 |
| Phone Number: | 9186822491 |
| Fax Number: | 9182682148 |
| NPI Enumeration Date: | 06/01/2007 |
| NPI Last Update Date: | 09/21/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |