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Individual

MR. SHAWN DAVID CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
B.A.

Contact information

Practice address
214 SW 30TH ST, OKLAHOMA CITY, OK 73109-6506
(405) 272-1610
Mailing address
529 SW 156TH CT, OKLAHOMA CITY, OK 73170-7619
(405) 833-1215

Taxonomy

Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary

Other

Enumeration date
02/06/2012
Last updated
02/06/2012
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