Shape Our Village, Llc.
NPI #1518821172 in Oklahoma City, Oklahoma
Provider Information
- NPI Number
- 1518821172
- Entity Type
- Organization
- Organization Name
- Shape Our Village, Llc.
- Primary Specialty
- Clinic/Center - Adolescent and Children Mental Health
- Enumeration Date
- Dec 9, 2025
- Last Updated
- Dec 9, 2025
Practice Location
- Address
- 410 WINDSOR RD
- City
- Oklahoma City
- State
- Oklahoma
- ZIP Code
- 73130-4943
- Phone
- (619) 201-4747
Authorized Official
- Name
- ERICKA DAWN BRAGGS, BCBA
- Title
- CEO
- Phone
- (619) 201-4747
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