Provider Demographics
NPI:1710762794
Name:STRAIN, SHEALYN
Entity type:Individual
Prefix:
First Name:SHEALYN
Middle Name:
Last Name:STRAIN
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 1:201 N CADDO ST
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-5239
Mailing Address - Country:US
Mailing Address - Phone:580-791-2706
Mailing Address - Fax:
Practice Address - Street 1:2121 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-6033
Practice Address - Country:US
Practice Address - Phone:405-857-8280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician