Provider Demographics
NPI:1215664735
Name:RICH, SHELBY MARIE (RBT)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:MARIE
Last Name:RICH
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17170 MILL FOREST RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4305
Mailing Address - Country:US
Mailing Address - Phone:832-240-4563
Mailing Address - Fax:
Practice Address - Street 1:17170 MILL FOREST RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4305
Practice Address - Country:US
Practice Address - Phone:832-240-4563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician