Provider Demographics
NPI:1326178021
Name:GUERRERO, JANESSA MARIE (BS)
Entity Type:Individual
Prefix:MRS
First Name:JANESSA
Middle Name:MARIE
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2507 HASKELL BLVD
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74403-3836
Mailing Address - Country:US
Mailing Address - Phone:918-686-6933
Mailing Address - Fax:
Practice Address - Street 1:4009 EUFAULA AVE
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74403-1132
Practice Address - Country:US
Practice Address - Phone:918-682-2841
Practice Address - Fax:918-682-3359
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)