Individual
MELISSA G SHULTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
1322 S CAMPBELL AVE, SPRINGFIELD, MO 65807-1445
(417) 893-7702
Mailing address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5065
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2011029179
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13800457
CAQH
MO
05
—
496597709
—
MO
Enumeration date
09/13/2011
Last updated
03/25/2019
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