Individual
SHAINA SARA YOHANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
9028 NW 84TH ST, YUKON, OK 73099-8677
(405) 824-9760
Mailing address
9028 NW 84TH ST, YUKON, OK 73099-8677
(405) 824-9760
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
N/A
—
Enumeration date
10/01/2020
Last updated
10/21/2020
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