Larson, Shelly J
Larson, Shelly J is an individual health care provider with primary practice located at 2 Wickersham St , Mangum OK 73554-9117. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Larson, Shelly J can be contacted via phone (580) 782-3337.Contact Information
Primary practice address
2 Wickersham St
Mangum OK 73554-9117
Phone: (580) 782-3337
Fax: (580) 782-3337
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 256 | Oklahoma |
Profile Details
| NPI number | 1891902409 |
|---|---|
| LBN Legal business name | Larson, Shelly J |
| Credentials | CADC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 16th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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