Individual
MRS. KARA SUE NICCUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
320 STUDENT UNION, STILLWATER, OK 74078
(918) 850-9498
Mailing address
802 PARK PLACE, STILLWATER, OK 74075
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
866
OK
106H00000X
Marriage & Family Therapist
Primary
1002
OK
Other
Enumeration date
04/01/2011
Last updated
05/07/2013
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