Individual
SHELBY LYNN BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1712 HENSLEY RD, FORT MILL, SC 29715-7026
(803) 650-8657
Mailing address
1712 HENSLEY RD, FORT MILL, SC 29715-7026
(803) 650-8657
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-345414
SC
Other
Enumeration date
05/19/2026
Last updated
05/19/2026
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