Provider Demographics
NPI:1578570214
Name:WOOLSEY, SHELLEY ANN (RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:ANN
Last Name:WOOLSEY
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 JEWETT ST
Mailing Address - Street 2:
Mailing Address - City:PEPPERELL
Mailing Address - State:MA
Mailing Address - Zip Code:01463-1220
Mailing Address - Country:US
Mailing Address - Phone:978-474-4478
Mailing Address - Fax:978-925-9127
Practice Address - Street 1:68 MAIN ST
Practice Address - Street 2:STE 3
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-3834
Practice Address - Country:US
Practice Address - Phone:978-474-4478
Practice Address - Fax:978-925-9127
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1196133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered