Most Relevant Information
Provider Data
| NPI Number: | 1003406893 |
| Provider Name: | SHANTHEL HOLLIDAY |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/25/2021 |
| Last Updated: | 01/25/2021 |
Provider Practice Location
5501 ANTIQUE ROSE WAY
RIVERBANK
CA
953679505
Practice Location Phone/Fax
| Phone: | 8665234268 |
| Fax: |
Provider Mailing Location
PO BOX 399318
SAN FRANCISCO
CA
941399318
Provider Mailing Phone/Fax
| Phone: | 8665234268 |
| Fax: |