| NPI | 1306405667 |
|---|---|
| Former Name | SHELBY JOHNCOX |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 95302) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 105670-1) |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2024-01-29 |