Jessica Lea Shores, M.S.W

NPI #1023215563 in Ada, Oklahoma

Provider Information

NPI Number: 1023215563
Entity Type: Individual
Name: Jessica Lea Shores, M.S.W
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Credential: M.S.W
Enumeration Date: Jun 28, 2007
Last Updated: Aug 28, 2008

Practice Location

Address: 111 E 12TH ST
City: Ada
State: Oklahoma
ZIP Code: 74820-6501
Phone: (580) 436-2690

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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