Individual
MR. MICKEY K. SHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
3110 HWY 425 SOUTH, PINE BLUFF, AR 71601
(870) 535-2273
Mailing address
2143 GRIDER FIELD LADD RD, PINE BLUFF, AR 71601-9712
(870) 535-5408
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
90-24E
AR
Other
Enumeration date
05/29/2007
Last updated
07/08/2007
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