Most Relevant Information
Provider Data
| NPI Number: | 1003015488 |
| Provider Name: | SHANNON WATTIE |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: | 240 |
Most Important Dates
| Enumeration Date: | 07/16/2007 |
| Last Updated: | 07/16/2007 |
Provider Practice Location
3000 UNITED FOUNDERS BLVD STE 239
OKLAHOMA CITY
OK
731124279
Practice Location Phone/Fax
| Phone: | 4058407040 |
| Fax: |
Provider Mailing Location
3000 UNITED FOUNDERS BLVD STE 239
OKLAHOMA CITY
OK
731124279
Provider Mailing Phone/Fax
| Phone: | 4058407040 |
| Fax: |