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Individual

SHANE MARQUIS TOMES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RBT

Contact information

Practice address
3580 HARGRAVE CT, HEBRON, KY 41048-6900
(859) 654-7288
Mailing address
3580 HARGRAVE CT, HEBRON, KY 41048-6900
(859) 654-7288

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB781270
KY

Other

Enumeration date
02/21/2023
Last updated
02/21/2023
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