Individual
JAKE ANTHONY MERRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10441 S REGAL BLVD, TULSA, OK 74133-7188
(405) 513-0664
Mailing address
13220 S 86TH EAST PL, BIXBY, OK 74008-3465
(405) 513-0664
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
1034
OK
Other
Enumeration date
06/15/2017
Last updated
06/15/2017
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