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General NPI Number Information
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NPI Number | 1538890702
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Entity Type | Organization
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Legal Business Name | BAY AREA BEHAVIOR CONSULTING
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Dates
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Enumeration Date | 06/20/2022
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Last Update Date | 06/20/2022
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Provider Practice Location Address
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Address Line | 2369 LARUE LN
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City | ASHWAUBENON
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State | WI
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Zip | 54313-5798
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Country | US
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Telephone | 815-651-0334
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Fax |
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Provider Business Mailing Address
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Address Line | 2369 LARUE LN
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City | ASHWAUBENON
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State | WI
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Zip | 54313-5798
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Country | US
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Telephone | 815-651-0334
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Fax |
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Authorized Official
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Title or Position | BOARD CERTIFIED BEHAVIOR ANALYST
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Name | SHAWNA DUNN
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Credential | MS, BCBA, LBA
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Telephone | 815-651-0334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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