Individual
MS. WANDA LEANNE SHOALS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BHRS
Contact information
Practice address
3621 N KELLEY AVE, SUITE 100, OKLAHOMA CITY, OK 73111-4520
(405) 524-5525
Mailing address
838 NE 70TH ST, OKLAHOMA CITY, OK 73105-6010
(405) 843-5951
(405) 843-5951
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OK
Other
Enumeration date
12/02/2011
Last updated
12/02/2011
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