| Doctor Name: | MISS RUTH MARIE SHALLEY |
| NPI Number: | 1265471197 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 34004443A |
| Business Practice Address: | 308 Medic Way Greencastle, IN - 461352296 |
| Business Phone Number: | 7656532669 |
| Business Fax Number: | 7656538671 |
| Mailing Address: | 156 Andrews Blvd, PLAINFIELD |
| State: | IN |
| Postal Code: | 461689769 |
| Phone Number: | 3173712302 |
| Fax Number: | 7656538671 |
| NPI Enumeration Date: | 06/06/2006 |
| NPI Last Update Date: | 07/23/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 34004443A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |