Perry, Andria Nicole

Perry, Andria Nicole is an sole proprietor health care provider with primary practice located at 801 E Main St , Tishomingo OK 73460-2351. She recently has only one registered license in Behavioral Health & Social Service Providers / Rehabilitation, which is considered as her primary health care specialty. Perry, Andria Nicole can be contacted via phone (580) 371-3799.

Contact Information

Primary practice address
801 E Main St Tishomingo OK 73460-2351
Phone: (580) 371-3799
Fax: (580) 371-2056
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Rehabilitation 103TR0400X

Profile Details

NPI number 1124381835
LBN Legal business name Perry, Andria Nicole
Credentials BS,BHRS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 18th, 2012
Last updated Jun 18th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124381835 NPPES
Oklahoma MEDICAID 200226970A

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