Individual
TERRY GLEN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
7146 S BRADEN, SUITE 500, TULSA, OK 74136
(918) 488-6165
(918) 488-8021
Mailing address
PO BOX 3010, MCALESTER, OK 74502-3010
(918) 426-6780
(918) 488-8021
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
373
OK
Other
Enumeration date
08/09/2006
Last updated
07/31/2013
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