Doctor Name: | NICOLE L SPRY |
NPI Number: | 1649495045 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 1028 Ne 4th Street Guymon, OK - 739421739 |
Business Phone Number: | 5806511114 |
Business Fax Number: | |
Mailing Address: | 1028 Ne 4th St, GUYMON |
State: | OK |
Postal Code: | 739425428 |
Phone Number: | 5804682798 |
Fax Number: | |
NPI Enumeration Date: | 04/13/2007 |
NPI Last Update Date: | 06/21/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |