Individual
SHAYLA ILLINGWORTH-FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1719 S LOCUST ST, GRAND ISLAND, NE 68801-8248
(402) 699-4902
Mailing address
211 GALVIN RD N, BELLEVUE, NE 68005-4852
(402) 933-0680
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/30/2025
Last updated
05/30/2025
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