Individual
JIMMY ROWDY SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2701 NW 39TH EXPY, OKLAHOMA CITY, OK 73112-3775
(405) 653-7870
Mailing address
2420 N CLASSEN BLVD, OKLAHOMA CITY, OK 73106
(405) 885-3507
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1376761585
OK
Other
Enumeration date
12/02/2024
Last updated
12/02/2024
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