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Individual
SHANDA ALLS
Active
Individual
SHANDA ALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0060003
OK
175T00000X
Peer Specialist
—
—
261QR0800X
Recovery Care Clinic/Center
—
—
Other
Enumeration date
01/14/2025
Last updated
01/14/2025
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