Individual
SHADRICA NICOLE MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCA
Contact information
Practice address
101 WELLESLY ST, SIMPSONVILLE, SC 29680-6444
(864) 483-8755
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
10/06/2023
Last updated
10/06/2023
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