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NPI Code Detail

MEDICARE: SHANNEN YAP BCBA

MEDICARE: SHANNEN YAP BCBA
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
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1922658996
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNEN YAP BCBA
Provider Business Mailing Address
First Line : 3020 UNIVERSITY AVE SE APT 202
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55414-3775
Country : US
Telephone Number : 414-249-9712
Fax Number :
Provider Business Practice Location Address
First Line : 434 HAYWARD AVE N
Second Line :
City : OAKDALE
State : MN
Zip : 55128-5379
Country : US
Telephone Number : 952-236-7891
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2019
Last Update Date : 01/07/2022

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