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General NPI Number Information
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NPI Number | 1417414392
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Entity Type | Individual
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Provider Name | SHANTELL JONES- DOYLE RBT
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Gender | Female
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Dates
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Enumeration Date | 02/27/2019
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 3880 CATALINA ST
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City | TITUSVILLE
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State | FL
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Zip | 32796-2211
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Country | US
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Telephone | 321-346-8450
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Fax | 772-219-1339
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Provider Business Mailing Address
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Address Line | 1558 LOMBARD ST NW
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City | PALM BAY
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State | FL
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Zip | 32907-7065
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Country | US
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Telephone | 321-458-8436
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-19-79449
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License Number State | FL
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