Most Relevant Information
Provider Data
| NPI Number: | 1003345869 |
| Provider Name: | SHALAH LARAE THOMPSON |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/06/2017 |
| Last Updated: | 06/06/2017 |
Provider Practice Location
11486 HIGHWAY 51
HULBERT
OK
744412648
Practice Location Phone/Fax
| Phone: | 9183164204 |
| Fax: |
Provider Mailing Location
4636 S HARVARD AVE
TULSA
OK
741352908
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |