Provider Demographics
NPI:1295039238
Name:WECKSTEIN, ASHLEY NICOLE (MED, LPC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICOLE
Last Name:WECKSTEIN
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7311 E AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:GLENCOE
Mailing Address - State:OK
Mailing Address - Zip Code:74032-5102
Mailing Address - Country:US
Mailing Address - Phone:918-652-5433
Mailing Address - Fax:
Practice Address - Street 1:2525 NW EXPRESSWAY
Practice Address - Street 2:SUITE 624-A
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-7227
Practice Address - Country:US
Practice Address - Phone:405-242-5070
Practice Address - Fax:405-242-5071
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-05
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor