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Individual
SHANA THEDFORD
Active
Individual
SHANA THEDFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RO
Taxonomy
Speciality
Code
Description
License number
State
156FC0800X
Contact Lens Technician/Technologist
—
MS
156FX1101X
Ophthalmic Assistant
—
MS
156FX1101X
Ophthalmic Assistant
Primary
—
NULL
156FX1101X
Ophthalmic Assistant
Primary
—
—
156FX1700X
Ocularist
—
NULL
156FX1800X
Optician
—
MS
171400000X
Health & Wellness Coach
—
MS
251V00000X
Voluntary or Charitable Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05986512
—
MS
01
—
16999022
CERTIFIED CHILDREN'S VISION SCREENER
NC
Enumeration date
03/19/2018
Last updated
01/14/2026
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