# SHANDA ALLS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1467262188
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 164W00000X | Licensed Practical Nurse | L0060003 | OK | Yes |
| 175T00000X | Peer Specialist | — | — | — |
| 261QR0800X | Recovery Care Clinic/Center | — | — | — |

## Other

- **Enumeration date:** 01/14/2025
- **Last updated:** 01/14/2025