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General NPI Number Information
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NPI Number | 1528486685
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Entity Type | Individual
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Provider Name | PAMELA D. SHELNUTT PLPC
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Gender | Female
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Dates
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Enumeration Date | 04/04/2014
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Last Update Date | 02/26/2021
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Provider Practice Location Address
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Address Line | 2423 WILLIAMS DR STE 108
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City | GEORGETOWN
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State | TX
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Zip | 78628-3269
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Country | US
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Telephone | 778-005-7228
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Fax |
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Provider Business Mailing Address
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Address Line | 205 E UNIVERSITY AVE STE 200
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City | GEORGETOWN
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State | TX
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Zip | 78626-6821
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Country | US
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Telephone | 512-686-0207
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2014007640
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License Number State | MO
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