Locke, Shellie Dee

Locke, Shellie Dee is an sole proprietor health care provider with primary practice located at 9020 15Th Ave , Kenosha WI 53143-6803. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Locke, Shellie Dee can be contacted via phone (708) 224-7442.

Contact Information

Primary practice address
9020 15Th Ave Kenosha WI 53143-6803
Phone: (708) 224-7442
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 2660-057 Wisconsin
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 071.007310 Illinois
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2660-057 Wisconsin
Behavioral Health & Social Service Providers / Clinical 103TC0700X 071.007310 Illinois

Profile Details

NPI number 1336319979
LBN Legal business name Locke, Shellie Dee
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 11th, 2008
Last updated Mar 11th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336319979 NPPES
Wisconsin MEDICAID 40994300

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