# DR. SHELLEY OLIVIA SUTTON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1942307814
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | 2003012262 | MO | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | 4301093327 | MI | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | C53616 | CA | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 03/22/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 177466 | BLUE CROSS BLUE SHIELD | MO |
| 05 | — | 208800300 | — | MO |