Provider Demographics
NPI:1306177753
Name:SIMS, SHATOYA K (MHR)
Entity Type:Individual
Prefix:MRS
First Name:SHATOYA
Middle Name:K
Last Name:SIMS
Suffix:
Gender:F
Credentials:MHR
Other - Prefix:
Other - First Name:SHATOYA
Other - Middle Name:K
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MHR
Mailing Address - Street 1:777 E 15TH ST
Mailing Address - Street 2:#217
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-5038
Mailing Address - Country:US
Mailing Address - Phone:405-501-2844
Mailing Address - Fax:
Practice Address - Street 1:777 E 15TH ST
Practice Address - Street 2:#217
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-5038
Practice Address - Country:US
Practice Address - Phone:405-501-2844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health