Shalissa Lyndzie Fellows

NPI #1881248433 in Herriman, Utah

Provider Information

NPI Number: 1881248433
Entity Type: Individual
Name: Shalissa Lyndzie Fellows
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Jul 31, 2019
Last Updated: Jul 31, 2019

Practice Location

Address: 13947 S NEWBURG DR
City: Herriman
State: Utah
ZIP Code: 84096-6787
Phone: (801) 506-6695

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Health Worker	172V00000X
Behavior Technician	106S00000X	Primary

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