Individual
SHAINA MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
117 ROGERS DRIVE, HOLDENVILLE, OK 74848
(405) 379-6668
Mailing address
P.O. BOX 590, HOLDENVILLE, OK 74848
(405) 584-0426
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/06/2013
Last updated
06/06/2013
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