Shelly J Larson in Mangum - Addiction (substance Use Disorder)
Shelly J Larson - NPI 1891902409
Shelly J Larson is a Addiction (substance Use Disorder) in Mangum, Oklahoma. Shelly J Larson practices all healthcare services and medical treatments related to Addiction (substance Use Disorder). The NPI Number for Shelly J Larson is 1891902409. The last update date is 2007-07-08.
Shelly J Larson's current location address is 2 Wickersham St, Mangum, Oklahoma. You can contact this provider via phone number 5807823337 and fax number 5807823337. The mailing address for Shelly J Larson is 2 Wickersham St, Mangum, Oklahoma. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shelly J Larson |
|---|---|
| Address | 2 Wickersham St, Mangum, Oklahoma |
| Phone Number | 5807823337 |
| Fax Number | 5807823337 |
| Sole Proprietor | N |
| Credentials | CADC |
NPI Number Detail
| NPI Number | 1891902409 |
|---|---|
| Provider Enumeration Date | 2007-05-16 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2 Wickersham St |
|---|---|
| City | Mangum |
| State | Oklahoma (OK) |
| Post Code | 735549117 |
| Phone Number | 5807823337 |
| Fax Number | 5807823337 |
Provider's Primary Taxonomy Detail
| Speciality | Addiction (substance Use Disorder) |
|---|---|
| Taxonomy | 101Ya0400X |
| Licence No | 256 |
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Definition: A counselor who helps people with alcohol, drug, gambling, internet, and other types of addictions. |
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Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Shelly J Larson by the Centers for Medicare & Medicaid Services?
The Shelly J Larson has been issued the NPI (National Provider Identifier) 1891902409, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Shelly J Larson's facilities are situated?
The facilities of Shelly J Larson are physically located at the following address: 2 Wickersham St, Mangum, OK, 735549117.
What is Shelly J Larson's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Shelly J Larson is Addiction (substance Use Disorder), and the taxonomy code that classifies this field of practice is 101Ya0400X.
On what date did the Shelly J Larson receive the assignment of its 1891902409 from the Centers for Medicare & Medicaid Services?
The Shelly J Larson was issued its 1891902409 by the Centers for Medicare & Medicaid Services on 2007-05-16.
As of what date were the details pertaining to Shelly J Larson last refreshed?
The information related to the Shelly J Larson, including its address, specialty, and other relevant details, was last updated on 2007-07-08.