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Individual

MRS. JILL NUCKOLLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
5350 S WESTERN AVE, SUITE 555, OKLAHOMA CITY, OK 73109-4520
(405) 631-4567
(405) 996-2113
Mailing address
6262 S SHERIDAN RD, TULSA, OK 74133-4055
(918) 492-8200
(918) 493-3268

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
08/27/2008
Last updated
04/27/2009
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