Provider Demographics
NPI:1528406477
Name:SANDERS, RIKKI JO
Entity Type:Individual
Prefix:MISS
First Name:RIKKI
Middle Name:JO
Last Name:SANDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E CREEK AVE
Mailing Address - Street 2:
Mailing Address - City:SALLISAW
Mailing Address - State:OK
Mailing Address - Zip Code:74955-4608
Mailing Address - Country:US
Mailing Address - Phone:918-774-6742
Mailing Address - Fax:918-776-0703
Practice Address - Street 1:210 E CREEK AVE
Practice Address - Street 2:
Practice Address - City:SALLISAW
Practice Address - State:OK
Practice Address - Zip Code:74955-4608
Practice Address - Country:US
Practice Address - Phone:918-774-6742
Practice Address - Fax:918-776-0703
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)