Individual
ELIZABETH SHELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1345 COMPANION CT STE 702, SUMTER, SC 29150-1749
(803) 905-5107
(615) 815-1946
Mailing address
PO BOX 931142, ATLANTA, GA 31193-1142
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-52150
SC
106S00000X
Behavior Technician
17-34049
SC
Other
Enumeration date
01/23/2018
Last updated
08/29/2024
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