Individual
BOBBY JOE BILLUPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
118 S MAIN ST, WAGONER, OK 74467-5221
(918) 485-1573
(918) 485-1575
Mailing address
118 S MAIN ST, WAGONER, OK 74467-5221
(918) 485-1573
(918) 485-1575
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200109760A
—
OK
Enumeration date
04/16/2010
Last updated
04/16/2010
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