=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871436493
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RILEY SHELTON
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/09/2026
-----------------------------------------------------
Last Update Date | 04/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2206 N KICKAPOO AVE
-----------------------------------------------------
City | SHAWNEE
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74804-2703
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-585-4530
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 101 PARKWAY DR
-----------------------------------------------------
City | MCLOUD
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74851-8089
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 580-799-9348
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------