Healthcare Provider Details

I. General information

NPI: 1629377965
Provider Name (Legal Business Name): SHAWN E HAPPE MS BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2011
Last Update Date: 03/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4502 CENTERVIEW SUITE 215
SAN ANTONIO TX
78228-1318
US

IV. Provider business mailing address

4615 GARDENDALE ST APARTMENT 506
SAN ANTONIO TX
78240-4200
US

V. Phone/Fax

Practice location:
  • Phone: 210-733-7440
  • Fax: 210-733-7570
Mailing address:
  • Phone: 901-896-5252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-05-2258
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: