Individual
SHELLEY M WARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1513 S 31ST ST, BROKEN ARROW, OK 74014-5041
(774) 535-2804
Mailing address
1513 S 31ST ST, BROKEN ARROW, OK 74014-5041
(774) 535-2804
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
222336
MA
1041C0700X
Clinical Social Worker
122447
MA
1041C0700X
Clinical Social Worker
Primary
7190
OK
1041C0700X
Clinical Social Worker
CSW02357
RI
Other
Enumeration date
11/28/2018
Last updated
10/09/2020
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