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General NPI Number Information
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NPI Number | 1487723763
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Entity Type | Individual
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Provider Name | SHELLEY LYNN HAMMES CADC III
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Gender | Female
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4404 STATE ROAD 70
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City | WEBSTER
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State | WI
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Zip | 54893-9251
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Country | US
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Telephone | 877-455-1901
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Fax | 715-349-8528
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Provider Business Mailing Address
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Address Line | 2440 4 1/8TH ST.
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City | CUMBERLAND
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State | WI
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Zip | 54829
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Country | US
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Telephone | 715-822-3898
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1178
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License Number State | WI
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