Individual
DR. SHANNON KYLE BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
620 ELM AVE RM 200, NORMAN, OK 73069-8801
(405) 325-2911
Mailing address
620 ELM AVE, NORMAN, OK 73069-8801
(405) 325-2911
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
OK
Other
Enumeration date
11/07/2012
Last updated
09/12/2018
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