Individual
JIMMY L WIDDIFIELD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., LPC
Contact information
Practice address
940 NE 13TH ST, 4N 4900, OKLAHOMA CITY, OK 73104-5008
(405) 271-8858
(405) 271-2931
Mailing address
4645 W NICKLAS AVE, APT. B, OKLAHOMA CITY, OK 73132-6933
(405) 412-1870
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/03/2008
Last updated
10/26/2011
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