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General NPI Number Information
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NPI Number | 1447639497
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Entity Type | Organization
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Legal Business Name | EDWARD NOLE COUNSELING
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Dates
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Enumeration Date | 05/22/2015
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Last Update Date | 05/22/2015
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Provider Practice Location Address
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Address Line | 1421 S BOSTON AVE
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City | TULSA
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State | OK
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Zip | 74119-3607
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Country | US
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Telephone | 918-694-6653
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Fax |
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Provider Business Mailing Address
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Address Line | 4912 E 22ND ST
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City | TULSA
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State | OK
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Zip | 74114-2206
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Country | US
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Telephone | 918-694-6653
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MR. EDWARD NOLE NOLE
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Credential | , MHR, LPC
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Telephone | 918-694-6653
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 5633
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License Number State | OK
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