Individual
JACOB ELI BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
100 DIVISION ST, CANADIAN, OK 74425-9750
(405) 430-3030
Mailing address
100 DIVISION ST, CANADIAN, OK 74425-9750
(405) 430-3030
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
OK
171100000X
Acupuncturist
BACU03012013-1
OK
Other
Enumeration date
10/26/2016
Last updated
08/19/2021
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