MR. Johnny Marvell Leake SR., M.ED

NPI #1003128745 in Oklahoma City, Oklahoma

Provider Information

NPI Number: 1003128745
Entity Type: Individual
Name: MR. Johnny Marvell Leake SR., M.ED
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Rehabilitation Counselor
Credential: M.ED
Enumeration Date: Jul 10, 2010
Last Updated: Jul 10, 2010

Practice Location

Address: 613 BATH CIR
City: Oklahoma City
State: Oklahoma
ZIP Code: 73117-3024
Phone: (405) 208-4045

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Rehabilitation Counselor	225C00000X	Primary

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