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General NPI Number Information
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NPI Number | 1437548930
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Entity Type | Organization
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Legal Business Name | KORI ZIBELL PLLC
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Dates
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Enumeration Date | 01/21/2015
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Last Update Date | 01/21/2015
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Provider Practice Location Address
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Address Line | 2529 S KELLY AVE C
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City | EDMOND
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State | OK
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Zip | 73013-2966
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Country | US
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Telephone | 405-850-5860
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Fax | 405-562-1975
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Provider Business Mailing Address
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Address Line | 2529 S KELLY AVE C
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City | EDMOND
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State | OK
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Zip | 73013-2966
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Country | US
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Telephone |
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Fax | 405-562-1975
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Authorized Official
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Title or Position | OWNER
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Name | KORI ZIBELL
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Credential | LADC
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Telephone | 405-850-5860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1013
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License Number State | OK
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