| Doctor Name: | MRS. SHELBY MARIE PELLETIER |
| NPI Number: | 1154684843 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC-C |
| License Number: | XL3707 |
| Business Practice Address: | 180 Main St Waterville, ME - 04901 |
| Business Phone Number: | 2078725300 |
| Business Fax Number: | |
| Mailing Address: | 180 Main St, WATERVILLE |
| State: | ME |
| Postal Code: | 049016666 |
| Phone Number: | 2078725300 |
| Fax Number: | |
| NPI Enumeration Date: | 06/19/2012 |
| NPI Last Update Date: | 09/27/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | XL3707 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |