Individual
SHELBY DIANE WAGES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
106 EVENING SHADE, HARVEST, AL 35749-4875
(256) 542-1284
(256) 542-1284
Mailing address
PO BOX 951, MADISON, AL 35758-0951
(256) 542-1284
(256) 858-1381
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/02/2017
Last updated
09/02/2017
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