Doctor Name: | JESSICA SHELHAMER |
NPI Number: | 1326494667 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 380 Freeville Rd Freeville, NY - 130689684 |
Business Phone Number: | 6078446490 |
Business Fax Number: | |
Mailing Address: | 380 Freeville Rd, FREEVILLE |
State: | NY |
Postal Code: | 130689684 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/05/2016 |
NPI Last Update Date: | 05/05/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |