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Individual

SHAWNNESSY JIWA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
J.D.

Contact information

Practice address
15211 NE 36TH ST, CHOCTAW, OK 73020-9032
(405) 824-9116
(888) 651-6707
Mailing address
15211 NE 36TH ST, CHOCTAW, OK 73020-9032
(405) 824-9116
(888) 651-6707

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
08/03/2015
Last updated
08/03/2015
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