Individual
SHAWNDA SHANA MAWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1215 11TH AVE NE, ARDMORE, OK 73401-7019
(580) 224-0205
Mailing address
1215 11TH AVE NE, ARDMORE, OK 73401-7019
(580) 224-0205
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/22/2013
Last updated
05/22/2013
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