Provider Demographics
NPI:1023179710
Name:BUTLER, JILL E
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:E
Last Name:BUTLER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:JILL
Other - Middle Name:E
Other - Last Name:DARLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10317 GREENBRIAR PL STE 400
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-7651
Mailing Address - Country:US
Mailing Address - Phone:405-838-5836
Mailing Address - Fax:
Practice Address - Street 1:10317 GREENBRIAR PL STE 400
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-7651
Practice Address - Country:US
Practice Address - Phone:918-745-0095
Practice Address - Fax:918-745-0190
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2023-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK756106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist