| Doctor Name: | MR. RONNIE E JESTES |
| NPI Number: | 1104042563 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | C.A.D.C |
| License Number: | 65 |
| Business Practice Address: | 600 Denver St Pawnee, OK - 740583522 |
| Business Phone Number: | 9187623686 |
| Business Fax Number: | 9157622617 |
| Mailing Address: | 45470 S 349 Rd, PAWNEE |
| State: | OK |
| Postal Code: | 740581060 |
| Phone Number: | 9187623851 |
| Fax Number: | |
| NPI Enumeration Date: | 04/17/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 65 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |