NPI 1003634478

Shane Micheal Hardemon

Practitioner Peer Specialist Blackwell, OK

Practice location

Address: 444 E College Ave, Blackwell, OK 74631-3319
Phone: (580) 401-7527

Registered specialties

Peer Specialist Primary

Other Service Providers Taxonomy 175T00000X

Other Peer Specialist providers in Oklahoma →

Registry record

NPI: 1003634478
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 Oct 2024
Record last updated: 2 Oct 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.