Individual
SHANE ALLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
2140 S HARVARD AVE, TULSA, OK 74114-1960
(918) 747-6377
Mailing address
114 E HELENA PL, BROKEN ARROW, OK 74012-8290
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
391
OK
Other
Enumeration date
10/06/2014
Last updated
10/06/2014
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