Provider Demographics
NPI:1487343182
Name:TROUSDALE, BOBBI JEAN (MED AND MS)
Entity type:Individual
Prefix:MS
First Name:BOBBI
Middle Name:JEAN
Last Name:TROUSDALE
Suffix:
Gender:F
Credentials:MED AND MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 W 11TH ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74801-6710
Mailing Address - Country:US
Mailing Address - Phone:405-275-3340
Mailing Address - Fax:
Practice Address - Street 1:326 W 11TH ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-6710
Practice Address - Country:US
Practice Address - Phone:405-275-3340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist