Provider Demographics
NPI:1871712356
Name:FEATHERSTONE, VICKI S (MS)
Entity type:Individual
Prefix:
First Name:VICKI
Middle Name:S
Last Name:FEATHERSTONE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 S BOSTON AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74119-1208
Mailing Address - Country:US
Mailing Address - Phone:918-510-5137
Mailing Address - Fax:918-382-7302
Practice Address - Street 1:616 S BOSTON AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74119-1208
Practice Address - Country:US
Practice Address - Phone:918-510-5137
Practice Address - Fax:918-382-7302
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor