Provider Demographics
NPI:1356451280
Name:DILL, SHELBY L (MS)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:L
Last Name:DILL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4122 COBIA ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32507-8143
Mailing Address - Country:US
Mailing Address - Phone:850-313-0255
Mailing Address - Fax:850-492-1039
Practice Address - Street 1:4122 COBIA ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32507-8143
Practice Address - Country:US
Practice Address - Phone:850-313-0255
Practice Address - Fax:850-492-1039
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health