Provider Demographics
NPI:1467796664
Name:LANG-MCHENRY, SHARTESE SHARIE (BA-BHRS)
Entity Type:Individual
Prefix:MRS
First Name:SHARTESE
Middle Name:SHARIE
Last Name:LANG-MCHENRY
Suffix:
Gender:F
Credentials:BA-BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 S LEWIS AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-7104
Mailing Address - Country:US
Mailing Address - Phone:918-779-4556
Mailing Address - Fax:918-895-6917
Practice Address - Street 1:5555 S LEWIS AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-7104
Practice Address - Country:US
Practice Address - Phone:918-779-4556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-12
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst