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Individual

SHAYNE MALONE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2444 COMMERCE RD STE 215, JACKSONVILLE, NC 28546-7560
(615) 294-1221
Mailing address
11406 LYNDENWOOD CT, CHESTERFIELD, VA 23838-5263
(615) 294-1221

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT-18-59119

Other

Enumeration date
07/05/2018
Last updated
07/05/2018
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