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Individual

TIARA LANIECE SHOALS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
9810 E 42ND ST STE 226, TULSA, OK 74146-3600
(918) 853-1358
Mailing address
9810 E 42ND ST STE 226, TULSA, OK 74146-3600
(918) 853-1358

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
101YP2500X
Professional Counselor
Primary
10773
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43-1236557
OK
Enumeration date
03/05/2014
Last updated
02/17/2026
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