Individual
DR. RICHARD SHELLENBERGER II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1851 STATE ROUTE 56, MADISON CORRECTIONAL INSTITUTION, LONDON, OH 43140-0740
(740) 852-9777
Mailing address
PO BOX 740, LONDON, OH 43140-0740
(740) 852-9777
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5275
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5275
OHIO PSYCHOLOGY LICENSE NUMBER
OH
Enumeration date
07/02/2014
Last updated
07/02/2014
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