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Individual

MISS NAKISHA MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1803 S WOOD DR, OKMULGEE, OK 74447-6825
(405) 458-9256
Mailing address
PO BOX 703130, TULSA, OK 74170-3130
(918) 813-4058

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
10089
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10089
OK
Enumeration date
07/15/2016
Last updated
09/15/2021
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