| NPI | 1104090745 |
|---|---|
| Former Name | LISA P SHELTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC S15221) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 17438) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 25760) | |
| 101YM0800X Counselor, Mental Health (Licence: NC 15221) | |
| 101YP2500X Counselor, Professional (Licence: IL 180.008438) | |
| 106H00000X Marriage & Family Therapist (Licence: IL 180.008438) | |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2023-03-21 |