Individual
BRANDIE SHELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BT
Contact information
Practice address
13393 BUFFALO RD, ARCHER LODGE, NC 27527-6998
(252) 315-8418
Mailing address
9109 MS KELLY RD, KENLY, NC 27542-7802
(252) 315-8418
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB967818
NC
Other
Enumeration date
12/25/2023
Last updated
12/25/2023
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