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1134855026
BLAKE SHELLY
FORT SMITH, AR
NPI
1134855026
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: AR 1-12-11455)
Enumeration Date
2022-07-25
Last Update Date
2022-07-25
Business Address
BLAKE SHELLY
5604 ELLSWORTH RD
FORT SMITH, AR 72903-3224
Phone number: 479-926-4673
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Mailing Address
BLAKE SHELLY
PO BOX 10921
FORT SMITH, AR 72917-0921
Phone number:
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