Individual
SHELLEY RIUTTA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MSE
Contact information
Practice address
2640 W POINT RD, GREEN BAY, WI 54304-1344
(920) 869-2711
Mailing address
PO BOX 365, ONEIDA, WI 54155-0365
(920) 869-2711
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
27361
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39727200
—
WI
Enumeration date
10/27/2005
Last updated
07/08/2007
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