Individual provider · NPI-1
Imisha Nikole Shelton
Religious Nonmedical Practitioner · Cedar Hill, TX
NPI number1548021371
StatusActive
Last updated in NPPESJan 18, 2024
Details
- NPI
- 1548021371
- Entity type
- Individual (NPI-1)
- Name
- Imisha Nikole Shelton
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 18, 2024
- Certification date
- Jan 18, 2024
- Last updated
- Jan 18, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 374K00000X | Religious Nonmedical Practitioner | – | – | Yes |
| 101YP1600X | Counselor, Pastoral | – | TX | |
| 106S00000X | Behavior Technician | RBT-23-265169 | TX | |
| 133N00000X | Nutritionist | – | – | |
| 133NN1002X | Nutritionist, Nutrition, Education | – | – | |
| 171400000X | Health & Wellness Coach | – | – | |
| 171M00000X | Case Manager/Care Coordinator | – | – | |
| 175T00000X | Peer Specialist | – | – | |
| 372500000X | Chore Provider | – | – | |
| 372600000X | Adult Companion | – | – | |
| 374U00000X | Home Health Aide | – | – | |
| 171W00000X | Contractor | – | – | |
| 172A00000X | Driver | – | – | |
| 175L00000X | Homeopath | – | – |
Practice location
1285 Longleaf DrCedar Hill, TX 75104-5457
Phone 214-296-7122
Mailing address
1285 Longleaf DrCedar Hill, TX 75104-5457
Phone 214-296-7122
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