Provider Demographics
NPI:1639605926
Name:BILODEAU, CHRISTOPHER J (BA PSYCHOLOGY)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:BILODEAU
Suffix:
Gender:M
Credentials:BA PSYCHOLOGY
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Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1537 SE 22ND AVE
Mailing Address - Street 2:APT 2
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-4890
Mailing Address - Country:US
Mailing Address - Phone:908-917-4053
Mailing Address - Fax:
Practice Address - Street 1:1537 SE 22ND AVE
Practice Address - Street 2:APT 2
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-4890
Practice Address - Country:US
Practice Address - Phone:908-917-4053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-04
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician