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NPI Code Detail

MEDICARE: MRS. NILA NICOLE RICKS MSW

MEDICARE: MRS. NILA NICOLE RICKS MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1124077094
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NILA NICOLE RICKS MSW
Provider Business Mailing Address
First Line : 13216 E 45TH ST
Second Line :
City : TULSA
State : OK
Zip : 74134-5815
Country : US
Telephone Number : 918-313-8610
Fax Number :
Provider Business Practice Location Address
First Line : 5525 E 51ST ST
Second Line : SUITE #400
City : TULSA
State : OK
Zip : 74135-7461
Country : US
Telephone Number : 918-388-6290
Fax Number : 918-388-6456
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2006
Last Update Date : 07/08/2007

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