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Individual

DELBERT SHIRLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
B.S.

Contact information

Practice address
620 W GRAND AVE, PONCA CITY, OK 74601-5123
(580) 762-1462
(580) 765-7299
Mailing address
620 W GRAND AVE, PONCA CITY, OK 74601-5123
(580) 762-1462
(580) 765-7299

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
OK

Other

Enumeration date
05/31/2007
Last updated
11/20/2012
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