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NPI Code Detail

MEDICARE: SHAYLA ELLIS M.ED., BCBA, LBA

MEDICARE: SHAYLA ELLIS M.ED., BCBA, LBA
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 Analyst4776TX

General Provider Information

NPI Number : 1770977282
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAYLA ELLIS M.ED., BCBA, LBA
Provider Business Mailing Address
First Line : 542 AMHERST ST STE B
Second Line :
City : NASHUA
State : NH
Zip : 03063-1016
Country : US
Telephone Number : 561-850-7812
Fax Number :
Provider Business Practice Location Address
First Line : 20718 PARK ROW DR
Second Line :
City : KATY
State : TX
Zip : 77449-5181
Country : US
Telephone Number : 561-850-7812
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2015
Last Update Date : 09/12/2025

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