Provider Demographics
NPI:1609079771
Name:DILLS, SHELLEY KAYE (MS, CGC)
Entity Type:Individual
Prefix:MS
First Name:SHELLEY
Middle Name:KAYE
Last Name:DILLS
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 BLUE IRIS DRIVE
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104
Mailing Address - Country:US
Mailing Address - Phone:404-275-4465
Mailing Address - Fax:
Practice Address - Street 1:1001 BLYTHE BLVD STE 200
Practice Address - Street 2:CLINICAL GENETICS
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5865
Practice Address - Country:US
Practice Address - Phone:704-381-6810
Practice Address - Fax:704-381-6811
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS