Shadava Deann Wallace
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 StHugo, OK 74743-5402
Phone: (580) 424-4239
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Specialties & licences
| Counselor (primary) | Taxonomy 101Y00000X (OK) |
|---|
Record details
| NPI number | 1215656517 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | August 22, 2022 |
| Last updated in NPPES | August 22, 2022 |
| Certification date | August 11, 2022 |
| Mailing address | 136 Meadowview St, Hugo, OK 74743-5402 |
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Tara A Myers, PSRS
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Michele Denise Shaffer, BS
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Patricia Wood
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