Individual
KATHLEEN MARIE NIBLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
10400 VINEYARD BLVD STE H200, OKLAHOMA CITY, OK 73120-3830
(405) 516-3248
(405) 516-3249
Mailing address
10400 VINEYARD BLVD STE H200, OKLAHOMA CITY, OK 73120-3830
(405) 607-2995
(405) 254-3042
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
0101391
NM
101Y00000X
Counselor
Primary
3442
OK
Other
Enumeration date
11/08/2007
Last updated
06/04/2019
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