Ellis, Shayla Renee
Ellis, Shayla Renee is an individual health care provider with primary practice located at 8027 Cooper Creek Blvd Ste 103 , University Park FL 34201-3002. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Ellis, Shayla Renee can be contacted via phone (941) 477-2080.Contact Information
Primary practice address
8027 Cooper Creek Blvd Ste 103
University Park FL 34201-3002
Phone: (941) 477-2080
Fax: (317) 520-8200
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavioral Analyst | 103K00000X | 1-08-4580 | Florida |
Profile Details
| NPI number | 1679724520 |
|---|---|
| LBN Legal business name | Ellis, Shayla Renee |
| Credentials | MS, BCBA |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 8th, 2008 |
| Last updated | Apr 20th, 2022 - about 3 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 | 1679724520 | NPPES |
| Florida | MEDICAID | 024004496 |
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