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General NPI Number Information
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NPI Number | 1730134032
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Entity Type | Individual
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Provider Name | SHELLEY D TINDELL-NODINE PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 02/01/2012
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Provider Practice Location Address
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Address Line | 4743 23RD ST N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33714-3229
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Country | US
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Telephone | 727-692-2511
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Fax | 727-522-7626
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Provider Business Mailing Address
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Address Line | PO BOX 7616
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City | ST PETERSBURG
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State | FL
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Zip | 33734-7616
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Country | US
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Telephone | 727-692-2511
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Fax | 727-522-7626
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY6748
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License Number State | FL
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