Healthcare Provider Details

I. General information

NPI: 1861324311
Provider Name (Legal Business Name): LORI K SHELL RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 WOOD DUCK CT
SAINT CLOUD FL
34772-7029
US

IV. Provider business mailing address

631 WOOD DUCK CT
SAINT CLOUD FL
34772-7029
US

V. Phone/Fax

Practice location:
  • Phone: 407-419-1399
  • Fax:
Mailing address:
  • Phone: 407-419-1366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: