Shadlow, Joanna Omega
Shadlow, Joanna Omega is an sole proprietor health care provider with primary practice located at 550 S Peoria Ave , Tulsa OK 74120-3820. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Shadlow, Joanna Omega can be contacted via phone (918) 588-1900.Contact Information
Primary practice address
550 S Peoria Ave
Tulsa OK 74120-3820
Phone: (918) 588-1900
Fax: (918) 582-6405
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 1172 | Oklahoma |
Profile Details
| NPI number | 1316123946 |
|---|---|
| LBN Legal business name | Shadlow, Joanna Omega |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 14th, 2008 |
| Last updated | Jun 18th, 2015 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316123946 | NPPES |
| Oklahoma | Other | 100732910-G | GROUP MEDICAID/SOONERCARE |
| Oklahoma | Other | 73-1042545 | GROUP MEDICAID/SOONERCARE |
| Oklahoma | Other | 73-1042545 | GROUP MEDICAID/SOONERCARE |
| Oklahoma | Other | 73-1042545 | GROUP MEDICAID/SOONERCARE |
| Oklahoma | Other | 731042545001 | GROUP MEDICAID/SOONERCARE |
| Oklahoma | Other | 100732910-A | GROUP MEDICAID/SOONERCARE |
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