Provider Demographics
NPI:1326269424
Name:BUTLER, MARQUS JASON (MHRM BHRS)
Entity Type:Individual
Prefix:
First Name:MARQUS
Middle Name:JASON
Last Name:BUTLER
Suffix:
Gender:M
Credentials:MHRM BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 SE 45TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73129-3201
Mailing Address - Country:US
Mailing Address - Phone:405-632-1900
Mailing Address - Fax:
Practice Address - Street 1:1140 NORTH HUDSON AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103
Practice Address - Country:US
Practice Address - Phone:405-272-0660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor