Individual
SHANIKQUA WOODARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BHRS
Contact information
Practice address
1800 NE 19TH ST, OKLAHOMA CITY, OK 73111-1418
(918) 852-4704
Mailing address
PO BOX 412, LANGSTON, OK 73050-0412
(918) 852-4704
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/23/2012
Last updated
10/23/2012
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