NPI 1003128745

Johnny Marvell Leake, MED

Practitioner Rehabilitation Counselor Oklahoma City, OK

Practice location

Address: 613 Bath Cir, Oklahoma City, OK 73117-3024
Phone: (405) 208-4045

Registered specialties

Rehabilitation Counselor Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225C00000X

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Registry record

NPI: 1003128745
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Jul 2010
Record last updated: 10 Jul 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.