Individual
JEREMY DAVID FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LMFT-US
Contact information
Practice address
3015 E SKELLY DR, SUITE 103, TULSA, OK 74105-6317
(918) 712-0859
Mailing address
3015 E SKELLY DR, SUITE 103, TULSA, OK 74105-6317
(918) 712-0859
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/04/2013
Last updated
06/30/2014
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