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General NPI Number Information
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NPI Number | 1982841458
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Entity Type | Individual
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Provider Name | SHELBY LEE CRESPO ND, LCSW, LMSW
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Gender | Female
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Dates
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Enumeration Date | 01/20/2009
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Last Update Date | 01/15/2024
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Provider Practice Location Address
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Address Line | 4111 BARKER DR
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City | CLIO
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State | MI
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Zip | 48420-9480
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Country | US
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Telephone | 810-210-2509
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Fax |
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Provider Business Mailing Address
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Address Line | 4111 BARKER DR
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City | CLIO
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State | MI
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Zip | 48420-9480
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Country | US
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Telephone | 810-210-2509
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801085449
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149018329
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 4385
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License Number State | OR
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