Healthcare Provider Details

I. General information

NPI: 1932772506
Provider Name (Legal Business Name): BAILY SHELOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2021
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 E HALL OF FAME AVE STE 250
STILLWATER OK
74075-5436
US

IV. Provider business mailing address

406 E HALL OF FAME AVE STE 250
STILLWATER OK
74075-5436
US

V. Phone/Fax

Practice location:
  • Phone: 918-216-0242
  • Fax:
Mailing address:
  • Phone: 918-216-0242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-73751
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: