| Doctor Name: | SHELLEY ANNE SOVIAK |
| NPI Number: | 1023103447 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LISW |
| License Number: | S0031843 |
| Business Practice Address: | 453 Allenby Dr Marysville, OH - 430408722 |
| Business Phone Number: | 9376420048 |
| Business Fax Number: | 9376421316 |
| Mailing Address: | 453 Allenby Drive, MARYSVILLE |
| State: | OH |
| Postal Code: | 43040 |
| Phone Number: | 9376420048 |
| Fax Number: | 9376421316 |
| NPI Enumeration Date: | 10/03/2006 |
| NPI Last Update Date: | 04/15/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | S0031843 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |