Individual
SHAWN BRADLEY STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
131 SUMMIT DR STE 402, PIKEVILLE, KY 41501-1580
(606) 430-2256
(606) 218-6577
Mailing address
131 SUMMIT DR STE 402, PIKEVILLE, KY 41501-1580
(606) 430-2256
(606) 218-6577
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/03/2024
Last updated
07/03/2024
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