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1487950788
RICKEY DEAN SHORT
NORMAN, OK
NPI
1487950788
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OK 94)
Enumeration Date
2011-02-03
Last Update Date
2011-02-03
Business Address
Mr. RICKEY DEAN SHORT LADC
3750 W MAIN ST SUITE 206
NORMAN, OK 73072-4657
Phone number: 405-447-8519
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Mailing Address
Mr. RICKEY DEAN SHORT LADC
4105 QUAIL DR
NORMAN, OK 73072-4518
Phone number: 405-447-8519
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