Individual
DEIDRA NICKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4930 S SHERIDAN RD, TULSA, OK 74145-5712
(918) 392-4008
Mailing address
17601 S 161ST EAST AVE, BIXBY, OK 74008-7504
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6528
OK
Other
Enumeration date
08/24/2017
Last updated
08/24/2017
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