person
Nicole Marie Cannon
Substance Abuse Rehabilitation Facility in Tulsa, Oklahoma
NPI 1124313788

Nicole Marie Cannon is a Substance Abuse Rehabilitation Facility based in Sand Springs, OK. Nicole Marie Cannon practices in Tulsa, OK. The NPI Number for Nicole Marie Cannon is 1124313788 and holds a License No. (Oklahoma).

The current practice location address for Nicole Marie Cannon is 6333 E Skelly Dr, Tulsa, OK and can be reached out via phone at 918-664-4224. You can also correspond with Nicole Marie Cannon through the mailing address at 1008 N ROOSEVELT AVE, SAND SPRINGS, OK - 74063-7355 (mailing address contact number: 318-805-3830).

Location: 6333 E Skelly Dr, Tulsa, OK, 74063-7355
person
Provider Profile Details
NPI Number
1124313788
Provider Name
Nicole Marie Cannon
Credential
Provider Entity Type
Individual
Gender
Female
Address
6333 E Skelly Dr, Tulsa, OK, 74063-7355
Phone Number
918-664-4224
Fax Number
Provider Enumeration Date
06/12/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
6333 E Skelly Dr
City
State
Zip
74135-6106
Phone Number
918-664-4224
Fax Number
person
Provider Business Mailing Address Details
Address
1008 N Roosevelt Ave
City
State
Zip
74063-7355
Phone Number
318-805-3830
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
-
Taxonomy
License No.
()
Definition
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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