Provider Demographics
NPI:1225303803
Name:LAW, BILLY
Entity Type:Individual
Prefix:
First Name:BILLY
Middle Name:
Last Name:LAW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4516 SUNNYVIEW DR APT 252
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73135-3145
Mailing Address - Country:US
Mailing Address - Phone:405-535-7479
Mailing Address - Fax:
Practice Address - Street 1:4516 SUNNYVIEW DR APT 252
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73135-3145
Practice Address - Country:US
Practice Address - Phone:405-535-7479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-15
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health