Provider Demographics
NPI:1881200558
Name:KRAUSCH, NICHOLE RAE (MS, CRC, NCC)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:RAE
Last Name:KRAUSCH
Suffix:
Gender:F
Credentials:MS, CRC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41623 STATE HIGHWAY 63
Mailing Address - Street 2:
Mailing Address - City:TALIHINA
Mailing Address - State:OK
Mailing Address - Zip Code:74571-2184
Mailing Address - Country:US
Mailing Address - Phone:918-413-2310
Mailing Address - Fax:
Practice Address - Street 1:1507 S MCKENNA ST
Practice Address - Street 2:
Practice Address - City:POTEAU
Practice Address - State:OK
Practice Address - Zip Code:74953-5207
Practice Address - Country:US
Practice Address - Phone:918-567-8121
Practice Address - Fax:918-647-8929
Is Sole Proprietor?:No
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor