| Doctor Name: | SHEILA J SELF |
| NPI Number: | 1053558379 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, LPC |
| License Number: | 3357 |
| Business Practice Address: | 601 N Grand Ave Tahlequah, OK - 744642302 |
| Business Phone Number: | 9184442120 |
| Business Fax Number: | 9184458234 |
| Mailing Address: | 601 N Grand Avenue, Northeastern State University Office Of Student Affairs TAHLEQUAH |
| State: | OK |
| Postal Code: | 74464 |
| Phone Number: | 9184442120 |
| Fax Number: | 9184582340 |
| NPI Enumeration Date: | 01/08/2009 |
| NPI Last Update Date: | 01/08/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 3357 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |