Healthcare Provider Details

I. General information

NPI: 1841584836
Provider Name (Legal Business Name): RONNY GERMANY MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2011
Last Update Date: 08/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6803 S WESTERN AVE SUITE 300
OKLAHOMA CITY OK
73139-1808
US

IV. Provider business mailing address

6803 S WESTERN AVE SUITE 300
OKLAHOMA CITY OK
73139-1808
US

V. Phone/Fax

Practice location:
  • Phone: 405-429-0123
  • Fax:
Mailing address:
  • Phone: 405-429-0123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: