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Individual

SYYRUS DASHAUN SHELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
9038 CROSS PARK DR STE 105, KNOXVILLE, TN 37923-4729
(865) 394-6612
(865) 315-7014
Mailing address
4839 KING GEORGE WAY, KNOXVILLE, TN 37918-4599
(865) 224-0964

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-291009
TN

Other

Enumeration date
10/21/2020
Last updated
08/17/2023
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