Individual
DR. VIVIAN ALLISON SHELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
6723 WHITTIER AVE, SUITE 207, MC LEAN, VA 22101-4522
(703) 475-6478
Mailing address
6723 WHITTIER AVE, SUITE 207, MC LEAN, VA 22101-4522
(703) 475-6478
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810003370
VA
103TC0700X
Clinical Psychologist
8990
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001065301
MEDICARE
—
01
—
1487892014
TUFTS
MA
01
—
213380
NEIGHBORHOOD HEALTH
MA
01
—
6901895/5887718
AETNA
—
Enumeration date
02/04/2009
Last updated
05/16/2019
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