| Doctor Name: | MARIE T SHELTON |
| NPI Number: | 1003953357 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 02075 |
| Business Practice Address: | 4425 Jefferson Ave Suite 106 Texarkana, AR - 718541535 |
| Business Phone Number: | 8702161700 |
| Business Fax Number: | 8707725965 |
| Mailing Address: | 4915 Texas Highway 43, BIVINS |
| State: | TX |
| Postal Code: | 755552053 |
| Phone Number: | 9037964749 |
| Fax Number: | |
| NPI Enumeration Date: | 01/30/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 02075 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |