Provider Demographics
NPI:1093126195
Name:STITES, JOHNETTE
Entity Type:Individual
Prefix:MRS
First Name:JOHNETTE
Middle Name:
Last Name:STITES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:POTEAU
Mailing Address - State:OK
Mailing Address - Zip Code:74953-3502
Mailing Address - Country:US
Mailing Address - Phone:918-649-0230
Mailing Address - Fax:918-649-1492
Practice Address - Street 1:401 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:POTEAU
Practice Address - State:OK
Practice Address - Zip Code:74953-3502
Practice Address - Country:US
Practice Address - Phone:918-649-0230
Practice Address - Fax:918-649-1492
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-12
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor