Individual
NICHELLE L INDERLIED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1222 10TH ST STE 211, WOODWARD, OK 73801-3156
(580) 256-8615
Mailing address
1222 10TH ST STE 211, WOODWARD, OK 73801-3156
(580) 256-8615
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/23/2019
Last updated
07/23/2019
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