Individual
JAKE O'BANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
3035 NW 63RD ST STE N200, OKLAHOMA CITY, OK 73116-3632
(405) 808-2160
Mailing address
16612 SUNNY HOLLOW RD, EDMOND, OK 73012-6745
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/06/2019
Last updated
07/31/2024
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