Organization Name: | PAULETTE JOBE LCSW |
NPI Number: | 1215328026 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAETON PAULETTE JOBE (SOLE MEMBER) |
Mailing Address: | 5480 Main Street Suite 104 Del City |
State: | OK US |
Postal Code: | 731159998 |
Phone Number: | 4057727440 |
Fax Number: | 4056017796 |
NPI Enumeration Date: | 02/16/2015 |
NPI Last Update Date: | 02/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 3944 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |