Provider Demographics
NPI:1225384118
Name:PROBY, SHIRLEY ANN
Entity Type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:ANN
Last Name:PROBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 NE 55TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73111-6706
Mailing Address - Country:US
Mailing Address - Phone:405-205-1313
Mailing Address - Fax:866-574-6407
Practice Address - Street 1:1320 NE 55TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73111-6706
Practice Address - Country:US
Practice Address - Phone:405-205-1313
Practice Address - Fax:866-574-6407
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-28
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor