Provider Demographics
NPI:1659656148
Name:ZIBELL, KORI
Entity Type:Individual
Prefix:
First Name:KORI
Middle Name:
Last Name:ZIBELL
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 1:3750 W MAIN ST # 145
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-4657
Mailing Address - Country:US
Mailing Address - Phone:405-850-5860
Mailing Address - Fax:405-321-8581
Practice Address - Street 1:3750 W MAIN ST # 145
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-4657
Practice Address - Country:US
Practice Address - Phone:405-850-5860
Practice Address - Fax:405-321-8581
Is Sole Proprietor?:No
Enumeration Date:2011-10-15
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200437270AMedicaid