Provider Demographics
NPI:1609353556
Name:PADILLA, SHALA NADINE (MSW)
Entity Type:Individual
Prefix:MISS
First Name:SHALA
Middle Name:NADINE
Last Name:PADILLA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2680 N HIGHWAY 88
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-0409
Mailing Address - Country:US
Mailing Address - Phone:918-341-7580
Mailing Address - Fax:918-341-7977
Practice Address - Street 1:2680 N HIGHWAY 88
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-0409
Practice Address - Country:US
Practice Address - Phone:918-341-7580
Practice Address - Fax:918-341-7977
Is Sole Proprietor?:No
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical