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General NPI Number Information
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NPI Number | 1346501731
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Entity Type | Individual
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Provider Name | SHELLEY SOLLARS MA, LLP
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Gender | Female
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Dates
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Enumeration Date | 06/03/2012
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Last Update Date | 06/03/2012
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Provider Practice Location Address
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Address Line | 725 S ADAMS RD SUITE 235
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City | BIRMINGHAM
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State | MI
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Zip | 48009-6902
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Country | US
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Telephone | 238-613-5377
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Fax | 248-646-9018
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Provider Business Mailing Address
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Address Line | 725 S ADAMS RD SUITE 235
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City | BIRMINGHAM
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State | MI
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Zip | 48009-6902
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Country | US
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Telephone | 238-613-5377
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Fax | 248-646-9018
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301006418
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License Number State | MI
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