Justin Lynn Cicotte

NPI #1013577139 in Vinita, Oklahoma

Provider Information

NPI Number: 1013577139
Entity Type: Individual
Name: Justin Lynn Cicotte
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Enumeration Date: Jun 20, 2019
Last Updated: Nov 24, 2021

Practice Location

Address: 405 E EXCELSIOR AVE
City: Vinita
State: Oklahoma
ZIP Code: 74301-4226
Phone: (918) 256-6476

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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