MEDICARE: MRS. SHAYLA MARIE PROGAR M.S., BCBA

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
1	103K00000X	Behavior Analyst	1524140	WI

General Provider Information

NPI Number	:	1467017590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHAYLA MARIE PROGAR M.S., BCBA

Provider Business Mailing Address
First Line	:	5325 WALL ST
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53718-7982
Country	:	US
Telephone Number	:	608-709-2182
Fax Number	:	608-216-2042

Provider Business Practice Location Address
First Line	:	5325 WALL ST
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53718-7982
Country	:	US
Telephone Number	:	608-709-2182
Fax Number	:	608-216-2042

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2019
Last Update Date	:	03/30/2026

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