MEDICARE: MRS. SHELNEKO TONI NORTHINGTON M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1811322472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHELNEKO TONI NORTHINGTON M.S.

Provider Business Mailing Address
First Line	:	18413 ABIERTO DR
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73012-9619
Country	:	US
Telephone Number	:	405-596-7544
Fax Number	:

Provider Business Practice Location Address
First Line	:	7901 NE 10TH ST
Second Line	:	A-209
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73110-3600
Country	:	US
Telephone Number	:	405-476-2722
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2013
Last Update Date	:	09/13/2013

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