Individual
SHANNON MARIE FICINUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PEER SPECIALIST
Contact information
Practice address
1015 W WASHBOURNE ST, JAY, OK 74346-4205
(844) 458-2100
Mailing address
520 S MAIN ST STE 139, GROVE, OK 74344-3497
(918) 964-1188
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
05/26/2026
Last updated
05/26/2026
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