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General NPI Number Information
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NPI Number | 1255742755
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Entity Type | Individual
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Provider Name | MS. SHELBY LYN-MARIE REMILLARD
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Gender | Female
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Dates
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Enumeration Date | 05/19/2014
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Last Update Date | 10/18/2019
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Provider Practice Location Address
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Address Line | 49 W 24TH ST STE 1004
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City | NEW YORK
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State | NY
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Zip | 10010-3543
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Country | US
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Telephone | 347-752-1157
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Fax |
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Provider Business Mailing Address
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Address Line | 49 W 24TH ST STE 1004
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City | NEW YORK
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State | NY
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Zip | 10010-3543
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Country | US
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Telephone |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 008787-1
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License Number State | NY
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