Maryott-Moore, Shelley Lynn
Maryott-Moore, Shelley Lynn is an individual health care provider with primary practice located at 921-14Th Ave. , Longview WA 98632. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Maryott-Moore, Shelley Lynn can be contacted via phone (360) 423-0203.Contact Information
Primary practice address
921-14Th Ave.
Longview WA 98632
Phone: (360) 423-0203
Fax: (360) 423-2311
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | LW00007954 | Washington |
Profile Details
| NPI number | 1720103708 |
|---|---|
| LBN Legal business name | Maryott-Moore, Shelley Lynn |
| Credentials | LICSW, GMHS, CMHS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 20th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720103708 | NPPES |
| Washington | Other | LW00007954 | LICSW |
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