Individual
SHANNON MARIE BURRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1087 E PARK BLVD STE 11, BOISE, ID 83712-7722
(208) 584-6130
Mailing address
5295 S MESA TRAIL WAY, MERIDIAN, ID 83642-8442
(208) 340-7855
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-16-24312
CA
103K00000X
Behavior Analyst
Primary
1-16-24312
ID
103K00000X
Behavior Analyst
Primary
1-16-24312
NV
222Q00000X
Developmental Therapist
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
12/15/2016
Last updated
07/24/2026
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