MEDICARE: SHAMICA SANON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	22302	OK
2	104100000X	Social Worker	8521	OK

General Provider Information

NPI Number	:	1841617511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAMICA SANON

Provider Business Mailing Address
First Line	:	313 TULLAHOMA DR
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73034-4721
Country	:	US
Telephone Number	:	405-706-4139
Fax Number	:

Provider Business Practice Location Address
First Line	:	313 TULLAHOMA DR
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73034-4721
Country	:	US
Telephone Number	:	405-706-4139
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2014
Last Update Date	:	06/01/2026

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Directions to “ SHAMICA SANON ” Practice Location

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