Individual
SCOTT SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BHRS
Contact information
Practice address
130 W STEVE OWENS BLVD, MIAMI, OK 74354-7629
(918) 542-2845
Mailing address
130 W STEVE OWENS BLVD, MIAMI, OK 74354-7629
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/27/2012
Last updated
01/27/2012
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