Provider Demographics
NPI:1396072435
Name:RITCHIE, SHELLY RENEE (LPP)
Entity type:Individual
Prefix:MRS
First Name:SHELLY
Middle Name:RENEE
Last Name:RITCHIE
Suffix:
Gender:F
Credentials:LPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 STATE ROUTE 716
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41102-8252
Mailing Address - Country:US
Mailing Address - Phone:606-928-1970
Mailing Address - Fax:606-928-1964
Practice Address - Street 1:831 STATE ROUTE 716
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41102-8252
Practice Address - Country:US
Practice Address - Phone:606-928-1970
Practice Address - Fax:606-928-1964
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-0037103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist