Individual
JILL NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2221 E MEMORIAL RD, EDMOND, OK 73013-5518
(405) 779-0131
Mailing address
3609 BAIRD DR, EDMOND, OK 73013-6332
(405) 779-0131
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3804
OK
Other
Enumeration date
10/04/2017
Last updated
10/04/2017
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