Individual
JACQUELYN ELIZABETH SHIVELEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC CDCA
Contact information
Practice address
800 GALLIA ST STE 600, PORTSMOUTH, OH 45662-4097
(740) 353-4673
(740) 353-5800
Mailing address
PO BOX 232, FRIENDSHIP, OH 45630-0232
(740) 981-6419
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1700664
OH
Other
Enumeration date
10/13/2017
Last updated
10/13/2017
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