Basic Information
| Provider Information | |||||||||
| NPI: | 1316574031 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DR. TONI SHELOW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7 WILSON LN | ||||||||
| Address2: | |||||||||
| City: | FLETCHER | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287329722 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282226048 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7 WILSON LN | ||||||||
| Address2: | |||||||||
| City: | FLETCHER | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287329722 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282226048 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2020 | ||||||||
| LastUpdateDate: | 03/24/2020 | ||||||||
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| AuthorizedOfficialLastName: | SHELOW | ||||||||
| AuthorizedOfficialFirstName: | TONI | ||||||||
| AuthorizedOfficialMiddleName: | LEE | ||||||||
| AuthorizedOfficialTitleorPosition: | PSYCHOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 8282226048 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PH.D. | ||||||||
| NPICertificationDate: | 03/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC2200X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent |
No ID Information.