Provider Demographics
NPI:1932401551
Name:DECK, SHIRLEY LYNN (BHRS)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:LYNN
Last Name:DECK
Suffix:
Gender:F
Credentials:BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 E RANDOLPH AVE
Mailing Address - Street 2:APT. 7D
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-4676
Mailing Address - Country:US
Mailing Address - Phone:580-402-1784
Mailing Address - Fax:580-237-7550
Practice Address - Street 1:3225 E RANDOLPH AVE
Practice Address - Street 2:APT. 7D
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-4676
Practice Address - Country:US
Practice Address - Phone:580-402-1784
Practice Address - Fax:580-237-7550
Is Sole Proprietor?:No
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor