Individual
MS. KHALILAH ALI NICHELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., BHRS
Contact information
Practice address
3621 N KELLEY AVE, OKLAHOMA CITY, OK 73111-4520
(405) 524-5525
Mailing address
5313 N TERRY AVE, OKLAHOMA CITY, OK 73111-6860
(405) 514-5327
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OK
Other
Enumeration date
09/13/2011
Last updated
09/13/2011
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