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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

SHELLY JO WAHLSTROM, CHT, PHD

Active Sole Proprietor

SHELLY JO WAHLSTROM, CHT, PHD is a 374K00000X healthcare provider located in ROY, Utah. NPI 1063303717 is currently active in the NPPES registry. Verify at CMS.

374K00000X · ROY, UT

Registration Details

NPI Number
1063303717
Provider Type
Individual
Gender
Female
NPI Issued
Jul 11, 2025 (1.1035647370095 yrs)
Last Updated
Jul 11, 2025
License
374K00000X (AZ)
Sole Proprietor
Yes

Practice Information

Address
2827 W 4400 S
ROY, UT, 840678951
Browse UT providers · Browse ZIP 84067
Phone
8016433211
Primary Specialty
374K00000X
374K00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.