Provider Demographics
NPI:1306110192
Name:WASHINGTON, SHAYLA (BHRS)
Entity type:Individual
Prefix:MRS
First Name:SHAYLA
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4765 SE 27TH ST
Mailing Address - Street 2:
Mailing Address - City:DEL CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73115-4129
Mailing Address - Country:US
Mailing Address - Phone:405-672-0413
Mailing Address - Fax:
Practice Address - Street 1:4765 SE 27TH ST
Practice Address - Street 2:
Practice Address - City:DEL CITY
Practice Address - State:OK
Practice Address - Zip Code:73115-4129
Practice Address - Country:US
Practice Address - Phone:405-672-0413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKH080899285101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health