Individual
JULIE SHOEMAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1219 K ST NW, ARDMORE, OK 73401-1801
(580) 798-4523
Mailing address
RR 1 BOX 9055, TALIHINA, OK 74571-9748
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
N080251541
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N080251541
DEPARTMENT OF PUBLIC SAFETY
OK
Enumeration date
02/06/2020
Last updated
02/06/2020
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