Provider Demographics
NPI:1619685377
Name:TORRENCE, SHELBY A (LADC-MH CANDIDATE)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:A
Last Name:TORRENCE
Suffix:
Gender:F
Credentials:LADC-MH CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7728 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74112-4724
Mailing Address - Country:US
Mailing Address - Phone:918-902-6922
Mailing Address - Fax:
Practice Address - Street 1:3124 E APACHE ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74110-2320
Practice Address - Country:US
Practice Address - Phone:918-902-6922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)