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General NPI Number Information
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NPI Number | 1386539500
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Entity Type | Individual
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Provider Name | SHELLEY WELBY TLLP
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Gender | Female
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 1349 S OTSEGO AVE STE 11
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City | GAYLORD
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State | MI
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Zip | 49735-9170
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Country | US
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Telephone | 772-678-1972
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Fax |
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Provider Business Mailing Address
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Address Line | 6604 WOODCOCK CT
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City | GAYLORD
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State | MI
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Zip | 49735
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Country | US
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Telephone | 989-370-8056
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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 | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number | 6362009967
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License Number State | MI
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