Individual
JEREMY MCCANDOR ARRISONTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
620 NW 5TH ST STE D, MOORE, OK 73160-3947
(405) 208-4469
Mailing address
1125 NW 47TH ST, OKLAHOMA CITY, OK 73118-5230
(054) 905-1341
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
OK
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
09/03/2020
Last updated
01/23/2024
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