Individual
SHELLY BOGANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2323 S HARVARD AVE, TULSA, OK 74114-3301
(918) 293-2140
Mailing address
409 N FRANKLIN AVE, SAND SPRINGS, OK 74063-6706
(918) 951-7634
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/13/2013
Last updated
03/13/2013
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