Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shadava Deann Wallace

Individual provider Counselor · NPI 1215656517

Shadava Deann Wallace is a Counselor in Hugo, Oklahoma. Practices as a sole proprietor. Licensed in Oklahoma.

Licensed in
OK
In the registry since
2022

Practice location Address checks out

136 Meadowview St
Hugo, OK 74743-5402
Phone: (580) 424-4239
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X (OK)

Record details

NPI number1215656517
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 22, 2022
Last updated in NPPESAugust 22, 2022
Certification dateAugust 11, 2022
Mailing address136 Meadowview St, Hugo, OK 74743-5402

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