SHANNON DEATHERAGE

ADA, OK
NPI1629528302
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy104100000X Social Worker
Enumeration Date2016-10-06
Last Update Date2016-10-06
Business Address
-- SHANNON DEATHERAGE BSW
3115 ARLINGTON ST
ADA, OK 74820-3085
Phone number: 580-332-6345
Mailing Address
-- SHANNON DEATHERAGE BSW
2119 HAWK CIR
ADA, OK 74820-6001
Phone number: 580-332-6345