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Individual

TAYLOR SHEA DOEDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BA, BHRS

Contact information

Practice address
3111 B N BROADWAY, POTEAU, OK 74953
(918) 647-2262
(918) 647-2282
Mailing address
3111 B N. BROADWAY, POTEAU, OK 74953
(918) 647-2262
(918) 647-2282

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
00000
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200123440A
OK
Enumeration date
03/02/2010
Last updated
03/02/2010
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