Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | ||
N | 106S00000X | Behavior Technician |
NPI | 1003330853 |
---|---|
Provider Name | Shelby Jade Thompson |
First Address | Tampa, FL 33634-1240 |
Second Address | Wesley Chapel, FL 33544-6962 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2017 |
Last Update Date | 24/09/2019 |