Individual
MRS. BREANNA BROOKE SHINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-US
Contact information
Practice address
3015 E SKELLY DR, TULSA, OK 74105-6317
(918) 718-0859
Mailing address
3015 E SKELLY DR, TULSA, OK 74105-6317
(316) 377-9464
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
05/24/2012
Last updated
07/29/2015
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