Individual
BILLY WIDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, NCC, LPC
Contact information
Practice address
12005 E 470 RD, CLAREMORE, OK 74017-3737
(918) 342-0770
(918) 342-0087
Mailing address
12005 E 470 RD, CLAREMORE, OK 74017-3737
(918) 342-0770
(918) 342-0087
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/09/2015
Last updated
06/02/2020
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