| Doctor Name: | MS. VIVIAN SHIMP |
| NPI Number: | 1134558547 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MBS |
| License Number: | 0568987 |
| Business Practice Address: | 303 Nw 3rd St Stigler, OK - 744622011 |
| Business Phone Number: | 9186355240 |
| Business Fax Number: | |
| Mailing Address: | Po Box 928, 303 Nw 3rd St. STIGLER |
| State: | OK |
| Postal Code: | 744620928 |
| Phone Number: | 9186355240 |
| Fax Number: | |
| NPI Enumeration Date: | 11/06/2013 |
| NPI Last Update Date: | 11/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YS0200X |
| License Number: | 0568987 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OK |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |