Organization
HOMEBASED SERVICES AND RESOURCES
Active
Organization
HOMEBASED SERVICES AND RESOURCES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA KAY SHORES LMFT, LADC (OWNER/EXECUTIVE DIRECTOR)
(918) 694-1999
Entity
Organization
Contact information
Practice address
904 NW 4TH ST, STIGLER, OK 74462-1652
(918) 967-8223
Mailing address
904 NW 4TH ST, STIGLER, OK 74462-1652
(918) 967-8223
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/05/2013
Last updated
08/23/2021
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