| Doctor Name: | MARY ANN SHOONECH |
| NPI Number: | 1114340874 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 816 N Ross Ave Dewey, OK - 740292134 |
| Business Phone Number: | 9185347772 |
| Business Fax Number: | |
| Mailing Address: | 816 N Ross, DEWEY |
| State: | OK |
| Postal Code: | 74029 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/30/2014 |
| NPI Last Update Date: | 01/30/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |