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Individual

SHELBY ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BA

Contact information

Practice address
193 MARKET ST, KINGSTON, PA 18704-5409
(570) 846-0455
Mailing address
3143 ESSEX RD, TOBYHANNA, PA 18466-8222

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
06/29/2017
Last updated
06/29/2017
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