Individual
SHELBY LYNN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
56 GAYMORE RD, PORT JEFFERSON STATION, NY 11776-1353
(631) 991-0543
Mailing address
225 BROADHOLLOW RD, MELVILLE, NY 11747-4822
(631) 385-7780
(646) 839-5781
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/30/2018
Last updated
10/30/2018
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