Individual
SHAKOTA MARY-MARIE WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1120 TARBY RD, POTEAU, OK 74953-5504
(800) 640-9741
Mailing address
PO BOX 179, STIGLER, OK 74462-0179
(918) 647-2155
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
01/30/2024
Last updated
01/30/2024
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