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1124313788
NICOLE MARIE CANNON
TULSA, OK
NPI
1124313788
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
324500000X Substance Abuse Rehabilitation Facility
Enumeration Date
2011-06-12
Last Update Date
2011-06-12
Business Address
-- NICOLE MARIE CANNON
6333 E SKELLY DR
TULSA, OK 74135-6106
Phone number: 918-664-4224
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Mailing Address
-- NICOLE MARIE CANNON
1008 N ROOSEVELT AVE
SAND SPRINGS, OK 74063-7355
Phone number: 318-805-3830
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