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NPI Code Detail

MEDICARE: SHANYETTE LOUIS RBT

MEDICARE: SHANYETTE LOUIS RBT
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1578276283
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANYETTE LOUIS RBT
Provider Business Mailing Address
First Line : PO BOX 360
Second Line :
City : KILLEEN
State : TX
Zip : 76540-0360
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2025 MEMORY LN STE 500
Second Line :
City : HARKER HEIGHTS
State : TX
Zip : 76548-7489
Country : US
Telephone Number : 254-317-5603
Fax Number : 512-746-0274
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2022
Last Update Date : 12/28/2022

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Directions to “ SHANYETTE LOUIS RBT” Practice Location

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