Individual
EDISON DALE JEFFUS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3220 S PEORIA AVE, SUITE 2, TULSA, OK 74105-2003
(918) 749-5506
(918) 749-5506
Mailing address
509 W 33RD ST, SAND SPRINGS, OK 74063-2934
(918) 241-1149
(918) 749-5506
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
636
OK
103TC0700X
Clinical Psychologist
636
OK
Other
Enumeration date
01/09/2007
Last updated
12/28/2011
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