Brewer, Jacob
Brewer, Jacob is an sole proprietor health care provider with primary practice located at 405 E Excelsior Ave , Vinita OK 74301-4226. He recently has only one registered license in Behavioral Health & Social Service Providers / Counseling, which is considered as his primary health care specialty. Brewer, Jacob can be contacted via phone (918) 256-6476.Contact Information
Primary practice address
405 E Excelsior Ave
Vinita OK 74301-4226
Phone: (918) 256-6476
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counseling | 103TC1900X |
Profile Details
| NPI number | 1508450149 |
|---|---|
| LBN Legal business name | Brewer, Jacob |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 24th, 2021 |
| Last updated | Feb 24th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508450149 | NPPES |
| Oklahoma | MEDICAID | 0HG71 |
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