Individual
MRS. CHRISTINE ANN NIDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHR, LPC
Contact information
Practice address
320 DEWEY AVE, POTEAU, OK 74953-4212
(918) 647-4196
Mailing address
39995 ROUND MTN LN, HOWE, OK 74940-7415
(918) 658-5027
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3928
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100731330-A
—
OK
Enumeration date
05/18/2010
Last updated
05/18/2010
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