Individual
SHELBY JENNINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
126 MILTON DR, GOOSE CREEK, SC 29445-4820
(843) 754-5600
Mailing address
126 MILTON DR, GOOSE CREEK, SC 29445-4820
(843) 754-5600
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/23/2024
Last updated
05/23/2024
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