Doctor Name: | NICOLE D PITRE |
NPI Number: | 1144341942 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, LPC |
License Number: | 3671 |
Business Practice Address: | 554 Mallard Ln Choctaw, OK - 730207182 |
Business Phone Number: | 4053900869 |
Business Fax Number: | |
Mailing Address: | 624 Nw 5th St, MOORE |
State: | OK |
Postal Code: | 731603924 |
Phone Number: | 4057993379 |
Fax Number: | |
NPI Enumeration Date: | 04/02/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 3671 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |