Provider Demographics
NPI:1437843984
Name:DEBERRY, JASHIMA AURRI JR (BS PSYCHOLOGY)
Entity Type:Individual
Prefix:MR
First Name:JASHIMA
Middle Name:AURRI
Last Name:DEBERRY
Suffix:JR
Gender:M
Credentials:BS PSYCHOLOGY
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Other - Credentials:
Mailing Address - Street 1:2727 S 137TH WEST AVE
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-5017
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2727 S 137TH WEST AVE
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-5017
Practice Address - Country:US
Practice Address - Phone:918-245-0231
Practice Address - Fax:918-241-5031
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator