Individual provider · Type 1 NPI

Shadava Deann Wallace

Counselor · Hugo, OK

NPI number 1215656517 Active

Practice location

136 Meadowview St
Hugo, OK 74743-5402

Call (580) 424-4239 Map

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000XNone listed

Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

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About NPI 1215656517

Shadava Deann Wallace's National Provider Identifier is 1215656517, issued on Aug 22, 2022. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Hugo, OK. The record was last updated on Aug 22, 2022.