# SHANA THEDFORD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1790289510
- **Gender:** F
- **Credential:** RO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 156FC0800X | Contact Lens Technician/Technologist | — | MS | — |
| 156FX1101X | Ophthalmic Assistant | — | MS | — |
| 156FX1101X | Ophthalmic Assistant | — | NULL | Yes |
| 156FX1101X | Ophthalmic Assistant | — | — | Yes |
| 156FX1700X | Ocularist | — | NULL | — |
| 156FX1800X | Optician | — | MS | — |
| 171400000X | Health & Wellness Coach | — | MS | — |
| 251V00000X | Voluntary or Charitable Agency | — | — | — |

## Other

- **Enumeration date:** 03/19/2018
- **Last updated:** 01/14/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 05986512 | — | MS |
| 01 | — | 16999022 | CERTIFIED CHILDREN'S VISION SCREENER | NC |