Individual
SHALENA CASANOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6128 E 38TH ST, TULSA, OK 74135-5832
(918) 313-4640
Mailing address
3415 E FAIRMONT PL, BROKEN ARROW, OK 74014-8860
(918) 313-4640
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
Other
Enumeration date
03/19/2024
Last updated
04/17/2024
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