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Individual

JUSTIN HAMMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.S., LMFT

Contact information

Practice address
1390 S DOUGLAS BLVD STE 102, MIDWEST CITY, OK 73130-5271
(405) 679-4977
Mailing address
1390 S DOUGLAS BLVD STE 102, MIDWEST CITY, OK 73130-5271
(405) 679-4977

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1348
OK
171M00000X
Case Manager/Care Coordinator

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1659685402
OK
Enumeration date
08/25/2011
Last updated
02/01/2021
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