| Doctor Name: | MS. SHIRLEY ANN WELLS |
| NPI Number: | 1003001504 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.ED., LPC |
| License Number: | 2002013515 |
| Business Practice Address: | 3309 S. Kingshighway Blvd Family Resource Center Saint Louis, MO - 63139 |
| Business Phone Number: | 3145341204 |
| Business Fax Number: | |
| Mailing Address: | 7511 Warwick Dr, SAINT LOUIS |
| State: | MO |
| Postal Code: | 631212436 |
| Phone Number: | 3143827997 |
| Fax Number: | 3143827997 |
| NPI Enumeration Date: | 09/08/2007 |
| NPI Last Update Date: | 09/21/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2002013515 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |