| NPI | 1598971657 |
|---|---|
| Former Name | DIANA KAY SHORES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OK 936) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 999) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-01-23 |