Individual
DIANA KAY SHORES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT, LADC
Contact information
Practice address
904 NW 4TH ST, STIGLER, OK 74462-1653
(918) 967-8223
(918) 967-8203
Mailing address
PO BOX 263, STIGLER, OK 74462-0263
(918) 694-1999
(918) 967-8203
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
999
OK
106H00000X
Marriage & Family Therapist
Primary
936
OK
Other
Enumeration date
05/15/2007
Last updated
01/23/2020
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