Provider Demographics
NPI:1962999631
Name:NUBIA FIESEL, LPC, PLLC
Entity type:Organization
Organization Name:NUBIA FIESEL, LPC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIORAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NUBIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FIESEL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-210-1100
Mailing Address - Street 1:3131 SW 89TH ST APT 11211
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-7944
Mailing Address - Country:US
Mailing Address - Phone:405-210-1100
Mailing Address - Fax:
Practice Address - Street 1:3321 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-2408
Practice Address - Country:US
Practice Address - Phone:405-210-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty