Provider Demographics
NPI:1215038948
Name:SCHROEDER, JULILYN ODELL (LPC)
Entity Type:Individual
Prefix:
First Name:JULILYN
Middle Name:ODELL
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:587 COUNTY ROAD 1250
Mailing Address - Street 2:
Mailing Address - City:POCASSET
Mailing Address - State:OK
Mailing Address - Zip Code:73079-8003
Mailing Address - Country:US
Mailing Address - Phone:405-459-9950
Mailing Address - Fax:
Practice Address - Street 1:411 W CHICKASHA AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:CHICKASHA
Practice Address - State:OK
Practice Address - Zip Code:73018-2505
Practice Address - Country:US
Practice Address - Phone:405-222-4786
Practice Address - Fax:405-222-1615
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3565101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional