Individual
MR. RICKEY DEAN SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
3750 W MAIN ST, SUITE 206, NORMAN, OK 73072-4657
(405) 447-8519
(405) 447-0739
Mailing address
4105 QUAIL DR, NORMAN, OK 73072-4518
(405) 447-8519
(405) 447-0739
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
94
OK
Other
Enumeration date
02/03/2011
Last updated
02/03/2011
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