Provider Demographics
NPI:1366782013
Name:BELCHER, SHANNON
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:BELCHER
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 1:2930 N SHARTEL AVE
Mailing Address - Street 2:#112
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-1034
Mailing Address - Country:US
Mailing Address - Phone:405-532-3446
Mailing Address - Fax:
Practice Address - Street 1:2930 N SHARTEL AVE
Practice Address - Street 2:#112
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-1034
Practice Address - Country:US
Practice Address - Phone:405-532-3446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-18
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management