Melanie Gayle Vidricksen

NPI #1184824120 in Muskogee, Oklahoma

Provider Information

NPI Number: 1184824120
Entity Type: Individual
Name: Melanie Gayle Vidricksen
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Mental Health
Enumeration Date: Jul 18, 2007
Last Updated: Jul 18, 2007

Practice Location

Address: 619 N MAIN ST
City: Muskogee
State: Oklahoma
ZIP Code: 74401-4431
Phone: (918) 682-2491

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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