Ellis, Shelby Lyn
Ellis, Shelby Lyn is an sole proprietor health care provider with primary practice located at 1975 Belmont Ave , Idaho Falls ID 83404-6409. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Ellis, Shelby Lyn can be contacted via phone (208) 716-1027.Contact Information
Primary practice address
1975 Belmont Ave
Idaho Falls ID 83404-6409
Phone: (208) 716-1027
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavior Technician | 106S00000X |
Profile Details
| NPI number | 1598383283 |
|---|---|
| LBN Legal business name | Ellis, Shelby Lyn |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 8th, 2020 |
| Last updated | Jul 8th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598383283 | NPPES |
| Idaho | Other | RK209943K | DRIVERS LICENCE |
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