Individual
SHELLEY RODERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2160 SANDY DR STE D, STATE COLLEGE, PA 16803-2205
(814) 380-9180
Mailing address
2160 SANDY DR STE D, STATE COLLEGE, PA 16803-2205
(814) 470-9601
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH003397
PA
Other
Enumeration date
05/14/2025
Last updated
05/14/2025
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