IndividualActive
Nicole Cannon
NPI 1124313788 · Substance Abuse Rehabilitation Facility · Tulsa, OK
Provider details
- NPI number
- 1124313788
- Entity type
- Individual
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Residential Treatment Facilities
Practice location
6333 E Skelly Dr
Tulsa, OK 74135-6106
Phone: (918) 664-4224
Approximate (ZIP-level) locationGet directions
Mailing address
1008 N Roosevelt Ave
Sand Springs, OK 74063-7355
Registry dates
- Enumerated
- 2011-06-12
- Last updated
- 2011-06-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.