Individual
SHANE M EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8875 HIDDEN RIVER PKWY STE 318, TAMPA, FL 33637-1035
(813) 367-2067
Mailing address
21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 91367-7807
(818) 345-2345
(000) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
E363793931500
FL
Other
Enumeration date
03/03/2020
Last updated
03/03/2020
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