Healthcare Provider Details

I. General information

NPI: 1578857009
Provider Name (Legal Business Name): SHELIA URBONAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2011
Last Update Date: 06/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 N FLORENCE AVE STE A
CLAREMORE OK
74017-4294
US

IV. Provider business mailing address

1222 N FLORENCE AVE STE A
CLAREMORE OK
74017-4294
US

V. Phone/Fax

Practice location:
  • Phone: 918-341-0087
  • Fax: 918-341-0081
Mailing address:
  • Phone: 918-341-0087
  • Fax: 918-341-0081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: