Individual
KATHRYN CORINNE DEVANE-SHELOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
705 E MAIN ST, WYTHEVILLE, VA 24382-3301
(276) 223-0672
Mailing address
705 E MAIN ST, WYTHEVILLE, VA 24382-3301
(276) 223-0672
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1818269
—
VA
Enumeration date
08/18/2021
Last updated
08/18/2021
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