Provider Demographics
NPI:1902820194
Name:HUFFMAN, SHIRLEY B (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHIRLEY
Middle Name:B
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1522
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28603-1522
Mailing Address - Country:US
Mailing Address - Phone:828-328-5122
Mailing Address - Fax:828-328-5122
Practice Address - Street 1:263 3RD AVE NW
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-4911
Practice Address - Country:US
Practice Address - Phone:828-322-4941
Practice Address - Fax:828-322-4931
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1064101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1327JOtherBC/BS
NC6102259Medicaid