Individual
HERBERT LEX SHALLCROSS IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6012 RIDGE AVE, PHILADELPHIA, PA 19128-1643
(215) 487-0904
(215) 487-3716
Mailing address
6012 RIDGE AVE, PHILADELPHIA, PA 19128-1643
(215) 487-0904
(215) 487-3716
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
02/28/2018
Last updated
02/28/2018
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