| Mr Shelly J Larson, CADC | |
|
2 Wickersham St, Mangum, OK 73554-9117 | |
| (580) 782-3337 | |
| (580) 782-3337 |
| Full Name | Mr Shelly J Larson |
|---|---|
| Gender | Female |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2 Wickersham St, Mangum, Oklahoma |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891902409 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 256 (Oklahoma) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Shelly J Larson, CADC 2 Wickersham St, Mangum, OK 73554-9117 Ph: (580) 782-3337 | Mr Shelly J Larson, CADC 2 Wickersham St, Mangum, OK 73554-9117 Ph: (580) 782-3337 |
Ms. Mary Margaret Braziel, B.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 2 Wickersham St, Mangum, OK 73554 Phone: 580-782-3337 Fax: 580-782-3338 | |
Mr. Keith D Hutton, BS Counselor Medicare: Not Enrolled in Medicare Practice Location: 2 Wickersham St, Mangum, OK 73554 Phone: 580-782-3337 Fax: 580-782-3338 | |
Mr. Robert Albert Milstead, B.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 2 Wickersham St, Mangum, OK 73554 Phone: 580-782-3337 | |
Elmer Shane Folster, BSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 2 Wickersham St, Mangum, OK 73554 Phone: 580-782-3337 | |
Mrs. Shelia Annette Holmes, BA Counselor Medicare: Not Enrolled in Medicare Practice Location: 2 Wickersham St, Mangum, OK 73554 Phone: 580-782-3337 Fax: 580-782-3338 | |
Ms. Chara Dannelle Avera, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2 Wickersham St, Mangum, OK 73554 Phone: 580-782-3337 | |
Miss Loriann Sanchez, BSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 2 Wickersham St, Mangum, OK 73554 Phone: 580-782-3337 |