Search › Oklahoma › 171M00000X
Shannon Fairless, BSW, CMII
NPI 1629305776 · on the registry since 2009 · sole proprietor
Practice
- Address
- 1222 10th St
Woodward, OK 73801 - Phone
- (580) 256-8615
- Organisation at this address
- State Of Oklahoma
Grand Lake Mental Health Center, Inc.Inferred from a shared address, not stated in the registry. - Clinicians at this address
- 106
Registry record
- Primary taxonomy
- 171M00000X
171M00000X
- Also registered as
- 106S00000X
101YM0800X - Sex
- Female
- Record last updated
- 2024-06-04
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma