Provider Demographics
NPI:1003528472
Name:MEALS, SHAELYNNE LOKALIA MARIE
Entity Type:Individual
Prefix:
First Name:SHAELYNNE
Middle Name:LOKALIA MARIE
Last Name:MEALS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 DONNER PASS DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-3401
Mailing Address - Country:US
Mailing Address - Phone:760-475-8043
Mailing Address - Fax:
Practice Address - Street 1:5755 S RAINBOW BLVD STE 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-2535
Practice Address - Country:US
Practice Address - Phone:702-412-8578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRBT3079106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician