Individual
MRS. JACQUELYN DAINE SHAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5004 SE 86TH ST, OKLAHOMA CITY, OK 73135-6197
(405) 417-8459
Mailing address
5004 SE 86TH ST, OKLAHOMA CITY, OK 73135-6197
(405) 417-8459
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/11/2010
Last updated
11/11/2010
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