Individual
MR. SHILOH WAYNE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED. LPC
Contact information
Practice address
14674 S HIGHWAY 169, OOLOGAH, OK 74053-3332
(580) 515-1167
Mailing address
14674 S HIGHWAY 169, OOLOGAH, OK 74053-3332
(088) 452-2515
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
135786
AK
101YP2500X
Professional Counselor
Primary
4309
OK
Other
Enumeration date
08/25/2008
Last updated
03/14/2025
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