Individual
JERMEL TREADWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2201 NW 122ND ST APT 2110, OKLAHOMA CITY, OK 73120-8414
(405) 474-8714
Mailing address
2201 NW 122ND ST APT 2110, OKLAHOMA CITY, OK 73120-8414
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
S080246637
—
OK
Enumeration date
08/28/2009
Last updated
08/28/2009
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