Individual
MICHAEL DWAYNE SHELBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
621 HARDEMEN, ITALY, TX 76651
(231) 462-5418
Mailing address
621 HARDEMAN, ITALY, TX 76651
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/13/2021
Last updated
07/13/2021
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