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Organization

OKLAHOMA DEPARTMENT OF MENTAL HEALTH AND SUBSTANCE ABUSE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. NISHA WILSON M.S., LPC (SUPERVISOR)
(405) 522-6853
Entity
Organization

Contact information

Practice address
1200 NE 13TH ST, OKLAHOMA CITY, OK 73117-1022
(405) 522-6853
Mailing address
1200 NE 13TH ST, P.O. BOX 53277, OKLAHOMA CITY, OK 73117-1022
(405) 522-6853

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2747
OK

Other

Enumeration date
10/03/2012
Last updated
10/03/2012
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