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Jordan Robert Reynolds
Mental Health Clinic/Center (Including Community Mental Health Center) in Ada, Oklahoma
NPI 1568740405

Jordan Robert Reynolds is a Mental Health Clinic/Center (Including Community Mental Health Center) based in Tishomingo, OK and is specialized in Mental Health (Including Community Mental Health Center). Jordan Robert Reynolds practices in Ada, OK. The NPI Number for Jordan Robert Reynolds is 1568740405 and holds a License No. (Oklahoma).

The current practice location address for Jordan Robert Reynolds is 1300 Hoppe Blvd Ste 6, Ada, OK and can be reached out via phone at 580-399-7653.

Location: 1300 Hoppe Blvd Ste 6, Ada, OK, 73460-3214
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1568740405
Provider Name
Jordan Robert Reynolds
Credential
Provider Entity Type
Individual
Gender
Male
Address
1300 Hoppe Blvd Ste 6, Ada, OK, 73460-3214
Phone Number
580-399-7653
Fax Number
Provider Enumeration Date
07/26/2011
Last Update Date
09/14/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1548339435 05 OK
institution
Provider Business Practice Location Address Details
Address
1300 Hoppe Blvd Ste 6
City
Ada
State
Oklahoma
Zip
74820-2319
Phone Number
580-399-7653
Fax Number
person
Provider Business Mailing Address Details
Address
1300 Hoppe Blvd Ste 6
City
Ada
State
Oklahoma
Zip
74820-2319
Phone Number
580-399-7653
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
()
Definition
Definition to come...
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