Individual
MS. KATHLEEN ELLISON NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
6417 S KINGSTON AVE, TULSA, OK 74136-2112
(918) 798-3196
Mailing address
6417 S KINGSTON AVE, TULSA, OK 74136-2112
(918) 798-3196
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3390
OK
Other
Enumeration date
02/02/2009
Last updated
04/07/2016
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