Individual
SHEA ELIZABETH SELF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2624 HOUGH RD, FLORENCE, AL 35630-1747
(256) 275-7089
Mailing address
2624 HOUGH RD, FLORENCE, AL 35630-1747
(256) 275-7089
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-08-4512
CA
Other
Enumeration date
07/31/2009
Last updated
10/01/2016
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