Gillette, Russell O

Gillette, Russell O is an individual health care provider with primary practice located at 1008 S Muskogee Ave , Tahlequah OK 74464-4734. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Gillette, Russell O can be contacted via phone (918) 458-0113.

Contact Information

Primary practice address
1008 S Muskogee Ave Tahlequah OK 74464-4734
Phone: (918) 458-0113
Fax: (918) 458-0075
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 271 Oklahoma
Behavioral Health & Social Service Providers / Professional 101YP2500X 2303 Oklahoma

Profile Details

NPI number 1497057558
LBN Legal business name Gillette, Russell O
Credentials LPC, LADC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 23rd, 2010
Last updated Nov 23rd, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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