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Individual
SHANNON LYNN WHITE
Active
Individual
SHANNON LYNN WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-11-9351
IN
103K00000X
Behavior Analyst
1300
TN
103K00000X
Behavior Analyst
Primary
—
—
174400000X
Specialist
1-11-9351
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-11-9351
BCBA
IN
01
—
1-11-9351
BCBA CERTIFICATE
—
05
—
Q090505
—
TN
Enumeration date
12/11/2011
Last updated
03/14/2024
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