Individual
MR. JEREMY EVELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
916 W GRAND ST, MARLOW, OK 73055-3248
(580) 656-2623
Mailing address
916 W GRAND ST, MARLOW, OK 73055-3248
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/02/2011
Last updated
09/27/2014
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