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NPI Code Detail

MEDICARE: JENNIFER SHONER RBT

MEDICARE: JENNIFER SHONER RBT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior AnalystBACB831051KY

General Provider Information

NPI Number : 1043901242
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER SHONER RBT
Provider Business Mailing Address
First Line : 539 HILLCREST DR
Second Line :
City : RADCLIFF
State : KY
Zip : 40160-2801
Country : US
Telephone Number : 517-262-0802
Fax Number :
Provider Business Practice Location Address
First Line : 298 MEDLEY CT
Second Line :
City : VINE GROVE
State : KY
Zip : 40175-8421
Country : US
Telephone Number : 270-352-1133
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2023
Last Update Date : 05/17/2023

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Directions to “ JENNIFER SHONER RBT” Practice Location

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