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Individual
RAY A. SHELLMIRE
Active
Individual
RAY A. SHELLMIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2376
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
167863 SC
OMAP
OR
Enumeration date
05/18/2007
Last updated
07/08/2007
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