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Individual

JONNY RAY BRANDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
304 DOLLINA DR, NORMAN, OK 73069-7570
(405) 488-4096
Mailing address
304 DOLLINA DR, NORMAN, OK 73069-7570
(405) 488-4096

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
OK
1041C0700X
Clinical Social Worker
Primary
4165
OK

Other

Enumeration date
04/25/2011
Last updated
06/21/2013
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