Provider Demographics
NPI:1831931666
Name:ATCHLEY, SHANDRA SHARLENE
Entity type:Individual
Prefix:
First Name:SHANDRA
Middle Name:SHARLENE
Last Name:ATCHLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHANDRA
Other - Middle Name:
Other - Last Name:ATCHLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2325 S HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-3300
Mailing Address - Country:US
Mailing Address - Phone:918-712-4301
Mailing Address - Fax:918-560-1399
Practice Address - Street 1:2325 S HARVARD AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-3300
Practice Address - Country:US
Practice Address - Phone:918-712-4301
Practice Address - Fax:918-560-1399
Is Sole Proprietor?:No
Enumeration Date:2024-06-11
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator