Provider Demographics
NPI:1962809483
Name:TIMMERMAN, JAMES
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:TIMMERMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5207 BEVERLY DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73105-1835
Mailing Address - Country:US
Mailing Address - Phone:405-921-9995
Mailing Address - Fax:
Practice Address - Street 1:5207 BEVERLY DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73105-1835
Practice Address - Country:US
Practice Address - Phone:405-921-9995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-26
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor