Individual
NICOLE LEE BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
448 36TH AVE NW, SUITE 101, NORMAN, OK 73072-4746
(405) 573-9905
(405) 701-0590
Mailing address
2524 NW 33RD ST, OKLAHOMA CITY, OK 73112-7628
(405) 568-0400
(888) 494-7966
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4183
OK
Other
Enumeration date
03/28/2012
Last updated
03/28/2012
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