Shadlow, Joanna Omega

Shadlow, Joanna Omega is an sole proprietor health care provider with primary practice located at 550 S Peoria Ave , Tulsa OK 74120-3820. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Shadlow, Joanna Omega can be contacted via phone (918) 588-1900.

Contact Information

Primary practice address
550 S Peoria Ave Tulsa OK 74120-3820
Phone: (918) 588-1900
Fax: (918) 582-6405
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 1172 Oklahoma

Profile Details

NPI number 1316123946
LBN Legal business name Shadlow, Joanna Omega
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 14th, 2008
Last updated Jun 18th, 2015 - about 11 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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Identifiers

StateTypeNumberIssuer
All States NPI 1316123946 NPPES
Oklahoma Other 100732910-G GROUP MEDICAID/SOONERCARE
Oklahoma Other 73-1042545 GROUP MEDICAID/SOONERCARE
Oklahoma Other 73-1042545 GROUP MEDICAID/SOONERCARE
Oklahoma Other 73-1042545 GROUP MEDICAID/SOONERCARE
Oklahoma Other 731042545001 GROUP MEDICAID/SOONERCARE
Oklahoma Other 100732910-A GROUP MEDICAID/SOONERCARE

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