Provider Demographics
NPI:1306686084
Name:WINETT, JOSEPHINE HOGAN
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:HOGAN
Last Name:WINETT
Suffix:
Gender:U
Credentials:
Other - Prefix:
Other - First Name:JOSHUA
Other - Middle Name:HOGAN
Other - Last Name:WINETT-BRUNGARDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1231 S JAMESTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74112-4921
Mailing Address - Country:US
Mailing Address - Phone:918-639-2702
Mailing Address - Fax:
Practice Address - Street 1:1229 E ADMIRAL BLVD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-1605
Practice Address - Country:US
Practice Address - Phone:918-398-8022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling