Shane Micheal Hardemon
Shane Micheal Hardemon is a Peer Specialist in Blackwell, Oklahoma. Practices as a sole proprietor. Licensed in Oklahoma.
- Licensed in
- OK
- In the registry since
- 2024
Practice location Address checks out
444 E College AveBlackwell, OK 74631-3319
Phone: (580) 401-7527
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Peer Specialist (primary) | Taxonomy 175T00000X (OK) |
|---|
Record details
| NPI number | 1003634478 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | October 2, 2024 |
| Last updated in NPPES | October 2, 2024 |
| Certification date | October 2, 2024 |
| Mailing address | 444 E College Ave, Blackwell, OK 74631-3319 |
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