Provider Demographics
NPI:1679989669
Name:SHELL, DEBRA
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:SHELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W ACRES ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-7602
Mailing Address - Country:US
Mailing Address - Phone:405-819-0103
Mailing Address - Fax:405-360-6856
Practice Address - Street 1:205 W ACRES ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-7602
Practice Address - Country:US
Practice Address - Phone:405-819-0103
Practice Address - Fax:405-360-6856
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-10
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor