NPI | 1053004143 |
---|---|
Other Name | JOE D SHELTON |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701011341) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0701011341) |
101YM0800X Counselor, Mental Health (Licence: VA 0701011341) | |
Enumeration Date | 2023-06-02 |
Last Update Date | 2023-09-28 |