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Individual

DR. SHANNON NICOLE DIAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
1921 STONECIPHER BLVD., CHICKASAW NATION MEDICAL CENTER, ADA, OK 74820
(806) 793-6160
Mailing address
CHICKASAW NATION MEDICAL CENTER, 1921 STONECIPHER BLVD., ADA, OK 74820
(580) 436-3980

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
106H00000X
Marriage & Family Therapist
Primary
1175
OK
106H00000X
Marriage & Family Therapist
201371
TX

Other

Enumeration date
12/11/2006
Last updated
09/19/2018
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