Provider Demographics
NPI:1003786310
Name:KENT, SHELITHA (RBT)
Entity type:Individual
Prefix:
First Name:SHELITHA
Middle Name:
Last Name:KENT
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8432 MAGNOLIA DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30238-3152
Mailing Address - Country:US
Mailing Address - Phone:678-353-5752
Mailing Address - Fax:
Practice Address - Street 1:1115 MOUNT ZION RD STE M
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260-2266
Practice Address - Country:US
Practice Address - Phone:943-200-0016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-11
Last Update Date:2025-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst