Individual
SHANNON RANAE GULLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
5850 U.S. 60 BOX 11, ASHLAND, KY 41102
(606) 929-9155
(606) 929-9155
Mailing address
5850 U.S. 60 BOX 11, ASHLAND, KY 41102
(606) 929-9155
(606) 929-9155
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30610026
—
KY
Enumeration date
08/12/2008
Last updated
11/10/2016
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