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General NPI Number Information
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NPI Number | 1154232494
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Entity Type | Individual
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Provider Name | SHAINA BODNER
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Gender | Female
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Dates
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Enumeration Date | 09/15/2026
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Last Update Date | 09/15/2026
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Provider Practice Location Address
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Address Line | 220 W GEORGIA AVE
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City | NAMPA
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State | ID
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Zip | 83686-2835
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Country | US
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Telephone | 425-368-3262
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Fax |
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Provider Business Mailing Address
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Address Line | 17232 SAND HOLLOW RD
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City | CALDWELL
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State | ID
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Zip | 83607-8655
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Country | US
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Telephone | 425-368-3262
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | ID
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