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General NPI Number Information
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NPI Number | 1083553200
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Entity Type | Individual
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Provider Name | BREANNA SHELTON PLPC
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Gender | Female
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Dates
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Enumeration Date | 03/25/2026
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Last Update Date | 03/25/2026
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Provider Practice Location Address
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Address Line | 15740 S OUTER 40 RD
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City | CHESTERFIELD
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State | MO
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Zip | 63017-2004
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Country | US
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Telephone | 314-251-2870
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Fax |
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Provider Business Mailing Address
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Address Line | 2613 COLUMBIA LAKES DR APT 2B
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City | COLUMBIA
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State | IL
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Zip | 62236-2612
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Country | US
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Telephone | 314-251-2870
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | IA-0008059010
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License Number State | MO
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