MS. Shelly Denise Jack, BHRS CM II

NPI #1447520135 in Atoka, Oklahoma

Provider Information

NPI Number: 1447520135
Entity Type: Individual
Name: MS. Shelly Denise Jack, BHRS CM II
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Credential: BHRS CM II
Enumeration Date: Jan 11, 2012
Last Updated: Oct 30, 2018

Practice Location

Address: 1088 S GIN RD
City: Atoka
State: Oklahoma
ZIP Code: 74525-7378
Phone: (580) 239-2071

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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