Provider Demographics
NPI:1972276103
Name:BILODEAU, GENE PAUL (MED)
Entity type:Individual
Prefix:MR
First Name:GENE
Middle Name:PAUL
Last Name:BILODEAU
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANACONDA
Mailing Address - State:MT
Mailing Address - Zip Code:59711-2933
Mailing Address - Country:US
Mailing Address - Phone:970-629-0091
Mailing Address - Fax:
Practice Address - Street 1:418 MAIN ST
Practice Address - Street 2:
Practice Address - City:ANACONDA
Practice Address - State:MT
Practice Address - Zip Code:59711-2933
Practice Address - Country:US
Practice Address - Phone:970-629-0091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-25
Last Update Date:2021-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT49416101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional