Individual
SHATOYA D GROOMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9614 E 26TH PL, TULSA, OK 74129-7014
(918) 933-0132
Mailing address
432 E F ST, JENKS, OK 74037-3339
(918) 933-0132
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
372600000X
Adult Companion
Primary
—
OK
Other
Enumeration date
05/05/2021
Last updated
12/29/2024
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