Individual
TAMMY SUE SHIRLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BACHELOR-BA
Contact information
Practice address
406WESTCHICKASAWWYNNEWOOD,OKLAHOMA73098, 202SOUTHWASHITA, WYNNEWOOD, OK 73098
(405) 665-2540
(405) 665-6396
Mailing address
406WESTCHICKASAW, 202SOUTHWASHITA, WYNNEWOOD, OK 73098
(405) 665-2540
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
103K0000X
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P5A4G5E4
—
OK
Enumeration date
12/14/2009
Last updated
12/14/2009
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