Provider Demographics
NPI:1346501731
Name:SOLLARS, SHELLEY (MA, LLP)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:
Last Name:SOLLARS
Suffix:
Gender:F
Credentials:MA, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 S ADAMS RD
Mailing Address - Street 2:SUITE 235
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-6902
Mailing Address - Country:US
Mailing Address - Phone:238-613-5377
Mailing Address - Fax:248-646-9018
Practice Address - Street 1:725 S ADAMS RD
Practice Address - Street 2:SUITE 235
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-6902
Practice Address - Country:US
Practice Address - Phone:238-613-5377
Practice Address - Fax:248-646-9018
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-03
Last Update Date:2012-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301006418103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist