| NPI | 1619633393 |
|---|---|
| Former Name | SHELBY MOAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: OK 353) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: OK RBT-21-157074) |
| Enumeration Date | 2021-11-16 |
| Last Update Date | 2024-11-13 |