Individual
MS. SHELLY D KANTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LADC/MH
Contact information
Practice address
1516 N LYNN RIGGS BLVD STE 100, CLAREMORE, OK 74017-3567
(918) 923-3802
(918) 923-3801
Mailing address
7010 S YALE AVE, SUITE 215, TULSA, OK 74136-5713
(918) 492-2554
(918) 494-9870
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1336
OK
101YM0800X
Mental Health Counselor
1336
OK
Other
Enumeration date
07/05/2013
Last updated
11/28/2018
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