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Mr. Johnny Dale Gilmore
Peer Specialist in Durant, Oklahoma
NPI 1285153155

Johnny Dale Gilmore is a Peer Specialist based in Durant, OK. Johnny Dale Gilmore practices in Durant, OK. The NPI Number for Johnny Dale Gilmore is 1285153155 and holds a License No. (Oklahoma).

The current practice location address for Johnny Dale Gilmore is 1315 W Texas St, Durant, OK and can be reached out via phone at 580-280-9883. You can also correspond with Johnny Dale Gilmore through the mailing address at 1315 W TEXAS ST, DURANT, OK - 74701-5749 (mailing address contact number: ).

Location: 1315 W Texas St, Durant, OK, 74701-5749
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1285153155
Provider Name
Johnny Dale Gilmore
Credential
Provider Entity Type
Individual
Gender
Male
Address
1315 W Texas St, Durant, OK, 74701-5749
Phone Number
580-280-9883
Fax Number
Provider Enumeration Date
09/12/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1315 W Texas St
City
Durant
State
Oklahoma
Zip
74701-5749
Phone Number
580-280-9883
Fax Number
person
Provider Business Mailing Address Details
Address
1315 W Texas St
City
Durant
State
Oklahoma
Zip
74701-5749
Phone Number
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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