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1982919684
JERRY FENNELL
CLAREMORE, OK
NPI
1982919684
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2010-08-18
Last Update Date
2010-08-18
Business Address
-- JERRY FENNELL
12005 E 470 RD
CLAREMORE, OK 74017-3737
Phone number: 918-342-0770
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Mailing Address
-- JERRY FENNELL
114 W DELAWARE AVE
NOWATA, OK 74048-2601
Phone number: 918-273-1841
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