Provider Demographics
NPI:1205198041
Name:HYSELL, VICKY LYNN (MC, BHRS)
Entity Type:Individual
Prefix:MS
First Name:VICKY
Middle Name:LYNN
Last Name:HYSELL
Suffix:
Gender:F
Credentials:MC, BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 S DREXEL AVE
Mailing Address - Street 2:APT. 2502
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-6487
Mailing Address - Country:US
Mailing Address - Phone:405-887-7198
Mailing Address - Fax:
Practice Address - Street 1:8800 S DREXEL AVE
Practice Address - Street 2:APT 2502
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-6487
Practice Address - Country:US
Practice Address - Phone:405-887-7198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health