MEDICARE: JAMIE M BULL LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	11642	OK
2	106H00000X	Marriage & Family Therapist	LF60059059	WA

General Provider Information

NPI Number	:	1811134349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE M BULL LMFT

Provider Business Mailing Address
First Line	:	7909 S ELDER AVE
Second Line	:
City	:	BROKEN ARROW
State	:	OK
Zip	:	74011-8273
Country	:	US
Telephone Number	:	509-760-1185
Fax Number	:

Provider Business Practice Location Address
First Line	:	5310 E 31ST ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74135-5012
Country	:	US
Telephone Number	:	918-600-3100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2009
Last Update Date	:	01/21/2025

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Directions to “ JAMIE M BULL LMFT” Practice Location

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