MS. Shasta Lynn Edmonds

NPI #1013622000 in Mt Juliet, Tennessee

Provider Information

NPI Number: 1013622000
Entity Type: Individual
Name: MS. Shasta Lynn Edmonds
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Jan 16, 2023
Last Updated: Jan 16, 2023

Practice Location

Address: 401 S MOUNT JULIET RD STE 235-118
City: Mt Juliet
State: Tennessee
ZIP Code: 37122-6359
Phone: (703) 506-0123

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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