Provider Demographics
NPI:1558757278
Name:COBB, JANET (CMII)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:COBB
Suffix:
Gender:F
Credentials:CMII
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 6
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:OK
Mailing Address - Zip Code:73439-0006
Mailing Address - Country:US
Mailing Address - Phone:580-564-5023
Mailing Address - Fax:580-795-7444
Practice Address - Street 1:134 12TH STREET
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701
Practice Address - Country:US
Practice Address - Phone:580-924-6363
Practice Address - Fax:580-924-0379
Is Sole Proprietor?:No
Enumeration Date:2015-04-09
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health