Individual
DR. SHOSHANNA S SHELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D
Contact information
Practice address
11 BEAVER MEADOW ROAD, NORWICH, VT 05055
(802) 649-1123
(802) 649-1141
Mailing address
PO BOX 4, NORWICH, VT 05055
(802) 649-1123
(802) 649-1141
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
3054
MA
103T00000X
Psychologist
Primary
401
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OVN0587
—
VT
Enumeration date
10/02/2006
Last updated
07/08/2007
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