Provider Demographics
NPI:1922233501
Name:SCRAPPER, JANINE EDITH
Entity type:Individual
Prefix:MS
First Name:JANINE
Middle Name:EDITH
Last Name:SCRAPPER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JANINE
Other - Middle Name:EDITH
Other - Last Name:MASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:109 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74464-4723
Mailing Address - Country:US
Mailing Address - Phone:918-431-0418
Mailing Address - Fax:918-431-0415
Practice Address - Street 1:109 W 2ND ST
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-4723
Practice Address - Country:US
Practice Address - Phone:918-431-0418
Practice Address - Fax:918-431-0415
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)