Individual
LADONNA KAY SHADLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CBHCM, BA
Contact information
Practice address
114 N GRAND AVE STE 418, OKMULGEE, OK 74447-4032
(918) 227-2016
Mailing address
PO BOX 93, SKIATOOK, OK 74070-0093
(918) 227-2016
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
104100000X
Social Worker
—
—
Other
Enumeration date
08/07/2009
Last updated
08/07/2009
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