Shadava Deann Wallace
Counselor · Hugo, OK
NPI number
1215656517
Practice location
136 Meadowview StHugo, OK 74743-5402
- Phone
- (580) 424-4239
NPI record
- NPI
- 1215656517
- Entity type
- Individual (Type 1)
- Enumeration date
- August 22, 2022
- Last updated
- August 22, 2022
- Certified
- August 11, 2022
- Sole proprietor
- Yes
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor Primary | 101Y00000X |
— | OK |
About Shadava Wallace
Shadava Deann Wallace is a healthcare provider registered in the NPI registry with the primary taxonomy Counselor (code 101Y00000X). The practice location is 136 Meadowview St, Hugo, OK 74743-5402. The NPI number 1215656517 was assigned on August 22, 2022 and the record was last updated on August 22, 2022.
Frequently asked questions
What is the NPI number of Shadava Deann Wallace?
The NPI number is 1215656517.
What is the phone number of Shadava Wallace?
The phone number listed for the practice location is (580) 424-4239.
Where is Shadava Wallace located?
136 Meadowview St, Hugo, OK 74743-5402.
What is the taxonomy code for Shadava Wallace?
The primary taxonomy code is 101Y00000X – Counselor.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.
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