Individual
CAITLIN M SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1414 E 28TH ST, BROOKLYN, NY 11210-5313
(718) 484-9219
Mailing address
10114 SHORE FRONT PKWY APT C, ROCKAWAY PARK, NY 11694-2930
(347) 439-1512
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-57280
NY
Other
Enumeration date
02/15/2022
Last updated
02/15/2022
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