Individual
SHANNON STOCKDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS ED, BCBA
Contact information
Practice address
125 W TAYLOR ST, KOKOMO, IN 46901-4554
(765) 419-0411
(800) 727-9914
Mailing address
125 W TAYLOR ST, KOKOMO, IN 46901-4554
(765) 419-0411
(800) 727-9914
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-79975
IN
106S00000X
Behavior Technician
RBT-19-96476
IN
Other
Enumeration date
01/10/2025
Last updated
04/03/2025
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