Individual
SHELBY FOX WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
613 N. 204TH AVE, ELKHORN, NE 68022
(402) 800-8784
Mailing address
613 N. 204TH AVE, ELKHORN, NE 68022
(402) 800-8784
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-34728
NE
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
01/08/2019
Last updated
12/03/2025
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