Healthcare Provider Details

I. General information

NPI: 1316075740
Provider Name (Legal Business Name): MRS. TERRI LYNN SHANAHAN SCHUELEIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 08/29/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 E 9TH ST STE 6
EDMOND OK
73034-5773
US

IV. Provider business mailing address

3044 STONYBROOK RD
OKLAHOMA CITY OK
73120-5716
US

V. Phone/Fax

Practice location:
  • Phone: 405-440-3034
  • Fax:
Mailing address:
  • Phone: 405-810-0054
  • Fax: 405-810-8977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: