Individual
JARON LAVELL SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1860 E 15TH ST, TULSA, OK 74104-4611
(918) 949-4430
Mailing address
1818 N MIDLAND AVE, TULSA, OK 74106-5620
(760) 277-7381
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OK
2255R0406X
Blind Rehabilitation Specialist/Technologist
—
—
Other
Enumeration date
07/21/2016
Last updated
03/17/2018
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