Provider Demographics
NPI:1376727784
Name:MUELLER, SHELLEY ANNE (MS, LCGC)
Entity Type:Individual
Prefix:MS
First Name:SHELLEY
Middle Name:ANNE
Last Name:MUELLER
Suffix:
Gender:F
Credentials:MS, LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 14TH ST STE 502
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-4019
Mailing Address - Country:US
Mailing Address - Phone:951-683-4675
Mailing Address - Fax:951-683-1148
Practice Address - Street 1:4000 14TH ST STE 502
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-4019
Practice Address - Country:US
Practice Address - Phone:951-683-4675
Practice Address - Fax:951-683-1148
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-20
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS