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Contact Information

SHELLIE D LOCKE, PhD
9020 15TH AVE
KENOSHA, WI53143-6803
 Phone: 708-224-7442
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Clinical Neuropsychologist

103G00000X
Indicates primary specialty

NPI Profile & details for SHELLIE D LOCKE · (Female)

NPI Number 1336319979
Status Active
Credentials PhD
Entity Individual
Enumeration date 03/11/2008
Last updated 03/11/2008 - About 18 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 071.007310
  • WI License # 2660-057
  • WI Medicaid 40994300
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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