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NPI Code Detail

MEDICARE: SHELLEY LEE M.A.

MEDICARE: SHELLEY LEE M.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor19563TX

General Provider Information

NPI Number : 1922014828
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELLEY LEE M.A.
Provider Business Mailing Address
First Line : 8402 AVENUE X
Second Line :
City : LUBBOCK
State : TX
Zip : 79423-3319
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3311 81ST ST STE F
Second Line :
City : LUBBOCK
State : TX
Zip : 79423-2008
Country : US
Telephone Number : 809-780-0003
Fax Number : 806-780-0007
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2006
Last Update Date : 07/08/2007

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