Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHADAVA DEANN WALLACE
Active Sole ProprietorSHADAVA DEANN WALLACE is a Counselor healthcare provider located in HUGO, Oklahoma. NPI 1215656517 is currently active in the NPPES registry. Verify at CMS.
Counselor · HUGO, OK
Registration Details
- NPI Number
- 1215656517
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 22, 2022 (3.9764674526245 yrs)
- Last Updated
- Aug 22, 2022
- Sole Proprietor
- Yes
Practice Information
- Address
-
136 MEADOWVIEW STHUGO, OK, 747435402Browse OK providers · Browse ZIP 74743
- Phone
- 5804244239
- Primary Specialty
-
Counselor
101Y00000X
Other Counselor Providers in HUGO, OK
| Name | Credential | NPI |
|---|---|---|
| KRISTIANNA CARSWELL | — | 1801086236 |
| JERRI S GRIFFIN | BA, PSRS | 1144547324 |
| DIANA CLARK | — | 1063723336 |
| TARA A MYERS | PSRS | 1376832311 |
| JANITRA D BOSTIC | PSRS | 1801185848 |
| TANDY LEAH LOW | — | 1528355336 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.