Individual
JASON SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
2810 W ETHEL AVE STE 1, MUNCIE, IN 47304-4402
(765) 282-8222
(765) 282-8222
Mailing address
2810 W ETHEL AVE STE 1, MUNCIE, IN 47304-4402
(765) 282-8222
(765) 282-8222
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-13-14641
IN
Other
Enumeration date
04/18/2014
Last updated
04/18/2014
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