Individual
JEREMY PAUL ELLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1120 E MAIN ST, NORMAN, OK 73071-5300
(405) 360-5100
(405) 364-3209
Mailing address
2101 MEMPHIS DR, NORMAN, OK 73071-2013
(405) 642-9369
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4410
OK
Other
Enumeration date
02/06/2008
Last updated
01/19/2024
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