Provider Demographics
NPI:1316725708
Name:LORD-PAWSON, SHELLI CLEMENS (PEERRECOVERYSPECIALI)
Entity type:Individual
Prefix:MRS
First Name:SHELLI
Middle Name:CLEMENS
Last Name:LORD-PAWSON
Suffix:
Gender:F
Credentials:PEERRECOVERYSPECIALI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ADOLESCENT & FAMILY HEALTH CENTER
Mailing Address - Street 2:13821 VILLAGE MILL DRIVE, SUITE B
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114
Mailing Address - Country:US
Mailing Address - Phone:804-794-8900
Mailing Address - Fax:804-378-2012
Practice Address - Street 1:ADOLESCENT & FAMILY HEALTH CENTER
Practice Address - Street 2:13821 VILLAGE MILL DRIVE, SUITE B
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114
Practice Address - Country:US
Practice Address - Phone:804-794-8900
Practice Address - Fax:804-378-2012
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist