Provider Demographics
NPI:1811134349
Name:BULL, JAMIE M (LMFT)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:M
Last Name:BULL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:M
Other - Last Name:SELTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:7909 S ELDER AVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74011-8273
Mailing Address - Country:US
Mailing Address - Phone:509-760-1185
Mailing Address - Fax:
Practice Address - Street 1:5310 E 31ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-5012
Practice Address - Country:US
Practice Address - Phone:918-600-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11642106H00000X
WALF60059059106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist