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Individual

MS. GINA DIANE RICE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
RR 2 BOX 374-5, VALLIANT, OK 74764-9807
(580) 212-6366
Mailing address
PO BOX 164, VALLIANT, OK 74764-0164
(580) 212-6366

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
163W00000X
Registered Nurse
Primary
83917
OK

Other

Enumeration date
10/16/2008
Last updated
01/03/2012
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