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1215613088
JAKE WILLARD
EDMOND, OK
NPI
1215613088
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: OK LPCCANDIDATE11434)
Enumeration Date
2023-06-26
Last Update Date
2023-06-26
Business Address
JAKE WILLARD MA
13707 FAIRHILL AVE
EDMOND, OK 73013
Phone number: 405-607-4041
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Mailing Address
JAKE WILLARD MA
13707 FAIRHILL AVE
EDMOND, OK 73013
Phone number: 405-607-4041
Copy
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