SHANNON NEVADA FAIRLESS

WOODWARD, OK
NPI1629305776
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Additional Taxonomies106S00000X Behavior Technician
101YM0800X Counselor, Mental Health
Enumeration Date2009-11-11
Last Update Date2024-06-04
Business Address
SHANNON NEVADA FAIRLESS BSW, CMII
1222 10TH ST
WOODWARD, OK 73801-3156
Phone number: 580-256-8615
Mailing Address
SHANNON NEVADA FAIRLESS BSW, CMII
1222 10TH ST
WOODWARD, OK 73801-3156
Phone number: 802-568-6155