Individual provider · Type 1 NPI

Shadrick Bullock

Peer Specialist · Owasso, OK

NPI number 1235025958 Active

Practice location

8344 N 117th East Ave
Owasso, OK 74055-2136

Call (918) 841-3794 Map

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist Primary 175T00000XNone listed

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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About NPI 1235025958

Shadrick Bullock's National Provider Identifier is 1235025958, issued on Jun 17, 2025. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Owasso, OK. The record was last updated on Jun 17, 2025.