Doctor Name: | MS. BARBARA K SHULLA |
NPI Number: | 1194732396 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC, LMFT |
License Number: | 000146 |
Business Practice Address: | 3148 Lake Rd N Brockport, NY - 144209402 |
Business Phone Number: | 5853140357 |
Business Fax Number: | |
Mailing Address: | Po Box 623, CLARKSON |
State: | NY |
Postal Code: | 144300623 |
Phone Number: | 5853143057 |
Fax Number: | |
NPI Enumeration Date: | 08/01/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 000146 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |