Individual
SHANICE WELLINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4451 PARLIAMENT PL, SUITE A, LANHAM, MD 20706-1843
(301) 577-4333
(301) 577-5180
Mailing address
10125 JUNCTION DR APT 133, ANNAPOLIS JUNCTION, MD 20701-1227
(267) 972-4783
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
LBA1683
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103K00000X
—
MD
Enumeration date
03/23/2017
Last updated
06/10/2024
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