Individual
SHELLY HUMMEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
220 S WHITE ST, WAKE FOREST, NC 27587-2781
(919) 880-2566
Mailing address
1009 BINKLEY CHAPEL CT, WAKE FOREST, NC 27587-4244
(919) 880-2566
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
861
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
141G8
BCBS PROVIDER NUMBER
NC
Enumeration date
01/08/2007
Last updated
07/20/2009
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