Provider Demographics
NPI:1003038183
Name:SHELTON, HOLLY MELISSA (BA)
Entity Type:Individual
Prefix:MISS
First Name:HOLLY
Middle Name:MELISSA
Last Name:SHELTON
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 N HARTFORD
Mailing Address - Street 2:#1113
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74075
Mailing Address - Country:US
Mailing Address - Phone:405-570-4939
Mailing Address - Fax:
Practice Address - Street 1:112 N MCKINLEY
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:OK
Practice Address - Zip Code:74834
Practice Address - Country:US
Practice Address - Phone:405-528-3040
Practice Address - Fax:405-240-5008
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor