person
Mr. Jimmy Todd Self, LPC
Mental Health Counselor in Wagoner, Oklahoma
NPI 1528171022

Jimmy Todd Self is a Mental Health Counselor based in Wagoner, OK and is specialized in Mental Health. Jimmy Todd Self practices in Wagoner, OK and has the professional credentials of LPC. The NPI Number for Jimmy Todd Self is 1528171022 and holds a License No. 3651 (Oklahoma).

The current practice location address for Jimmy Todd Self is 32270 E 722 Dr, Wagoner, OK and can be reached out via phone at 918-485-9277. You can also correspond with Jimmy Todd Self through the mailing address at 32270 E 722 DR, WAGONER, OK - 74467-7411 (mailing address contact number: 918-485-9277).

Location: 32270 E 722 Dr, Wagoner, OK, 74467-7411
person
Provider Profile Details
NPI Number
1528171022
Provider Name
Jimmy Todd Self
Credential
LPC
Provider Entity Type
Individual
Gender
Male
Address
32270 E 722 Dr, Wagoner, OK, 74467-7411
Phone Number
918-485-9277
Fax Number
Provider Enumeration Date
08/17/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
32270 E 722 Dr
City
State
Zip
74467-7411
Phone Number
918-485-9277
Fax Number
person
Provider Business Mailing Address Details
Address
32270 E 722 Dr
City
State
Zip
74467-7411
Phone Number
918-485-9277
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
3651 (Oklahoma)
Definition
Definition to come...
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