Individual
JIMMY LEE COUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
107 N MAIN ST, KINGFISHER, OK 73750-2730
(405) 872-6824
Mailing address
2712 SE 94TH ST, MOORE, OK 73160-9153
(405) 659-8937
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/18/2018
Last updated
03/13/2026
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