Individual
LILI-SHELBY FENAUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2314 6TH AVE SE STE D, DECATUR, AL 35601-6565
(256) 621-2244
(800) 607-1947
Mailing address
1100 ENTERPRISE WAY NW APT 1304, HUNTSVILLE, AL 35806-3021
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
21-169925
AL
Other
Enumeration date
06/01/2021
Last updated
06/01/2021
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