Provider Demographics
NPI:1912292459
Name:STRICKLAND, JUDY KAY (LBP)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:KAY
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:LBP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUGO
Mailing Address - State:OK
Mailing Address - Zip Code:74743-6237
Mailing Address - Country:US
Mailing Address - Phone:580-326-7477
Mailing Address - Fax:580-326-6400
Practice Address - Street 1:117 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:OK
Practice Address - Zip Code:74743-6237
Practice Address - Country:US
Practice Address - Phone:580-326-7477
Practice Address - Fax:580-326-6400
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0210101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100750190Medicaid