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Individual

MR. JIMMY RYAN LEVERETTE II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1607 PROFESSIONAL CIR, YUKON, OK 73099-6314
(405) 265-2800
Mailing address
4401 NW 39TH ST APT 316, OKLAHOMA CITY, OK 73112-2838
(405) 819-5802

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
08/22/2007
Last updated
02/22/2011
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