Jerry Wade is a Peer Specialist based in Ada, OK. Jerry Wade practices in Ada, OK. The NPI Number for Jerry Wade is 1396471231 and holds a License No. (Oklahoma).
The current practice location address for Jerry Wade is 301 W 4Th St, Ada, OK and can be reached out via phone at 580-257-2444.
Location: 301 W 4Th St, Ada, OK, 74820-3411
Provider Profile Details
NPI Number
1396471231
Provider Name
Jerry Wade
Credential
Provider Entity Type
Individual
Gender
Male
Address
301 W 4Th St, Ada, OK, 74820-3411
Phone Number
580-257-2444
Fax Number
Provider Enumeration Date
07/25/2022
Last Update Date
03/10/2024
Provider Business Practice Location Address Details
Address
301 W 4Th St
City
State
Zip
74820-3411
Phone Number
580-257-2444
Fax Number
Provider Business Mailing Address Details
Address
301 W 4Th St
City
State
Zip
74820-3411
Phone Number
580-257-2444
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
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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