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NPI Code Detail

MEDICARE: SHELLEY CRANE BCBA

MEDICARE:   SHELLEY  CRANE  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
1103K00000XBehavior Analyst1-17-27368IL

General Provider Information

NPI Number : 1952894529
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELLEY CRANE BCBA
Provider Business Mailing Address
First Line : 412 E 19TH AVE
Second Line :
City : COAL VALLEY
State : IL
Zip : 61240-9561
Country : US
Telephone Number : 815-912-2551
Fax Number :
Provider Business Practice Location Address
First Line : 3402 ELMORE AVE
Second Line :
City : DAVENPORT
State : IA
Zip : 52807-2594
Country : US
Telephone Number : 563-259-6084
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2018
Last Update Date : 04/18/2026

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Directions to “ SHELLEY CRANE BCBA” Practice Location

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