Individual
NICOLE MEDAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 J T STITES BLVD, SALLISAW, OK 74955-9323
(918) 775-7787
(918) 775-0328
Mailing address
19973 S 590 RD, WELLING, OK 74471-2411
(253) 678-7098
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/27/2025
Last updated
08/27/2025
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