| NPI | 1659946325 |
|---|---|
| Former Name | SHELBY LYNN WALDRON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 10001051) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2021-05-25 |
| Last Update Date | 2023-11-13 |