Individual
TRACEE SHELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRPA
Contact information
Practice address
610 N STATE ST, SYRACUSE, NY 13203-1709
(315) 748-0187
Mailing address
1684 US ROUTE 11, TULLY, NY 13159-3310
(315) 569-2480
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/27/2024
Last updated
03/27/2024
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