Provider Demographics
NPI:1316322910
Name:SHELBY'S BEHAVIOR SOLUTIONS
Entity type:Organization
Organization Name:SHELBY'S BEHAVIOR SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT BCBA
Authorized Official - Prefix:
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWD
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:813-433-4138
Mailing Address - Street 1:18157 SANDY POINTE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3308
Mailing Address - Country:US
Mailing Address - Phone:813-433-4138
Mailing Address - Fax:813-994-2735
Practice Address - Street 1:18157 SANDY POINTE DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3308
Practice Address - Country:US
Practice Address - Phone:813-433-4138
Practice Address - Fax:813-994-2735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-24
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-15-19187251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health