Individual
SHANDALYN RAYNE DEVOLLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
510 UPLAND ST, KENAI, AK 99611-8028
(907) 335-2700
Mailing address
1550 E 74TH AVE., ANCHORAGE, AK 99507
(907) 929-5826
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
AK
373H00000X
Day Training/Habilitation Specialist
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
12/02/2020
Last updated
07/25/2022
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