Healthcare Provider Details

I. General information

NPI: 1205371028
Provider Name (Legal Business Name): NANDEE WALKER NCC, LPC-S, RPT-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2017
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10310 N 138TH EAST AVE STE 104
OWASSO OK
74055-4611
US

IV. Provider business mailing address

10310 N 138TH EAST AVE STE 104
OWASSO OK
74055-4611
US

V. Phone/Fax

Practice location:
  • Phone: 918-408-6893
  • Fax:
Mailing address:
  • Phone: 918-408-6893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberOK07175
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: