Individual
MRS. SHELBY GONSALVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPMFT
Contact information
Practice address
4 FULLER ST, ALEXANDRIA BAY, NY 13607-1316
(315) 482-2511
Mailing address
6454B WINTERHAVEN DR, FORT DRUM, NY 13603-2093
(912) 439-1841
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
—
Other
Enumeration date
06/06/2022
Last updated
06/06/2022
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