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Search › Oklahoma › 104100000X

Shonta Crowder

NPI 1538457569 · on the registry since 2011 · sole proprietor

Practice

Address
3606 Idaho Ave
Bartlesville, OK 74006
Phone
(918) 337-8080
Fax
(918) 337-8099
Organisation at this address
Legacy'S Impact Intervention L.L.C
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
104100000X
104100000X
Also registered as
101YM0800X
1041C0700X
Licence states on file
OK
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2023-11-27

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma