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General NPI Number Information
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NPI Number | 1023359734
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Entity Type | Individual
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Provider Name | MS. DENISE LASHAUN SHAW
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Gender | Female
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Dates
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Enumeration Date | 03/05/2013
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Last Update Date | 03/05/2013
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Provider Practice Location Address
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Address Line | 2828 NW 57TH ST STE 302
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-7070
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Country | US
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Telephone | 405-840-1253
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Fax |
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Provider Business Mailing Address
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Address Line | 833 ENGLEWOOD RD
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City | DEL CITY
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State | OK
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Zip | 73115-1333
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Country | US
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Telephone | 405-618-8420
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XM0800X
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Taxonomy Name | Mental Health Occupational Therapist
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License Number | 261QM0801X
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License Number State | OK
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