Individual
NATHAN BILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16445 MIDWAY DR, POTEAU, OK 74953-7414
(918) 649-7584
Mailing address
16445 MIDWAY DR, POTEAU, OK 74953-7414
(918) 649-7584
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
103TR0400X
Rehabilitation Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200226970A
—
OK
Enumeration date
09/12/2012
Last updated
09/04/2015
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