Healthcare Provider Details
I. General information
NPI: 1174480339
Provider Name (Legal Business Name): DENISHA SHEMWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8115 MAPLE LAWN BLVD STE 350
FULTON MD
20759-2683
US
IV. Provider business mailing address
8115 MAPLE LAWN BLVD STE 350
FULTON MD
20759-2683
US
V. Phone/Fax
- Phone: 513-512-0030
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: