| NPI | 1528373362 |
|---|---|
| Former Name | SHELLY GUILLORY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP129246) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: UT 4963175-3102) | |
| Enumeration Date | 2010-08-17 |
| Last Update Date | 2022-12-01 |