Individual
MRS. JEN SHANSHAN STUART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LMSW
Contact information
Practice address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(405) 361-4698
Mailing address
1607 ABE MARTIN DR, NORMAN, OK 73071-7449
(405) 361-4698
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7901
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3333333
MEDICARE AND MEDICAID
—
Enumeration date
06/03/2021
Last updated
09/28/2021
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