Dreadfulwater, Shannon

Dreadfulwater, Shannon is an sole proprietor health care provider with primary practice located at 1140 Mayberry Dr , Tahlequah OK 74464-4603. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Dreadfulwater, Shannon can be contacted via phone (918) 453-1108.

Contact Information

Primary practice address
1140 Mayberry Dr Tahlequah OK 74464-4603
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X

Profile Details

NPI number 1689987059
LBN Legal business name Dreadfulwater, Shannon
Credentials LPC-CANDIDATE
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 14th, 2010
Last updated Jul 14th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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