Individual
ADAM SHELP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12875 CUMMING HWY # 4, CANTON, GA 30115-4884
(770) 240-0163
Mailing address
5850 CREST OAK WAY, CUMMING, GA 30028-4018
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-112818
GA
Other
Enumeration date
02/19/2020
Last updated
02/19/2020
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