Individual provider · Type 1 NPI

Jake Willard, MA

Mental Health Counselor · Edmond, OK

NPI number 1215613088 Active

Practice location

13707 Fairhill Ave
Edmond, OK 73013

Fax (405) 463-0090

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XLPCCANDIDATE11434 (OK)

Mental Health Counselor: Definition to come...

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About NPI 1215613088

Jake Willard, MA's National Provider Identifier is 1215613088, issued on Jun 26, 2023. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Edmond, OK. The record was last updated on Jun 26, 2023.