Doctor Name: | MRS. JAYME L RUSSELL-CAREY |
NPI Number: | 1770904815 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 209 W Broadway St Okemah, OK - 748592618 |
Business Phone Number: | 9186232922 |
Business Fax Number: | |
Mailing Address: | 127 N 6th St, OKEMAH |
State: | OK |
Postal Code: | 748592418 |
Phone Number: | 4052211225 |
Fax Number: | |
NPI Enumeration Date: | 12/16/2013 |
NPI Last Update Date: | 12/16/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |