Individual
JESAKAH RAE GATHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 N MERIDIAN AVE STE 201N, OKLAHOMA CITY, OK 73107-6553
(405) 601-8876
Mailing address
PO BOX 61, BINGER, OK 73009-0061
(405) 234-7972
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/03/2025
Last updated
02/03/2025
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