Provider Demographics
NPI:1215266184
Name:WEBB, JEANNE MOFIELD
Entity type:Individual
Prefix:DR
First Name:JEANNE
Middle Name:MOFIELD
Last Name:WEBB
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:JEANNE
Other - Middle Name:PATRICIA
Other - Last Name:WEBB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:4300 MOW-WAY ROAD
Mailing Address - Street 2:REYNOLDS ARMY COMMUNITY HOSPITAL
Mailing Address - City:FORT SILL
Mailing Address - State:OK
Mailing Address - Zip Code:73503
Mailing Address - Country:US
Mailing Address - Phone:580-558-2647
Mailing Address - Fax:580-558-2314
Practice Address - Street 1:4301 NW MOW WAY RD
Practice Address - Street 2:
Practice Address - City:FORT SILL
Practice Address - State:OK
Practice Address - Zip Code:73503-9018
Practice Address - Country:US
Practice Address - Phone:580-558-2647
Practice Address - Fax:580-558-2314
Is Sole Proprietor?:No
Enumeration Date:2009-12-23
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20040056A103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist