Individual provider · Type 1 NPI

Nicole Marie Cannon

Substance Abuse Rehabilitation Facility · Tulsa, OK

NPI number 1124313788 Active

Practice location

6333 E Skelly Dr
Tulsa, OK 74135-6106

Call (918) 664-4224 Map

Mailing address

1008 N Roosevelt Ave
Sand Springs, OK 74063-7355

Specialties and licenses

TaxonomyCodeLicense
Substance Abuse Rehabilitation Facility Primary 324500000XNone listed

Substance Abuse Rehabilitation Facility: A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

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About NPI 1124313788

Nicole Marie Cannon's National Provider Identifier is 1124313788, issued on Jun 12, 2011. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Tulsa, OK. The record was last updated on Jun 12, 2011.