Individual
MR. JAKE AARON ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
200 WHITE EAGLE DR, PONCA CITY, OK 74601-8315
(580) 765-2501
Mailing address
404 REDBIRD DR, PONCA CITY, OK 74601-1408
(918) 884-9844
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5472
OK
Other
Enumeration date
01/07/2013
Last updated
02/28/2024
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