Provider Demographics
NPI:1619168432
Name:SHELTON, TERRI LIZABETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:TERRI
Middle Name:LIZABETH
Last Name:SHELTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:330 S GREENE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-2659
Mailing Address - Country:US
Mailing Address - Phone:336-217-9732
Mailing Address - Fax:336-217-9750
Practice Address - Street 1:330 S GREENE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2659
Practice Address - Country:US
Practice Address - Phone:336-217-9732
Practice Address - Fax:336-217-9750
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2104103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent