Individual
SHANE G WALTERS SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
71 RAYMOND RD, WEST HARTFORD, CT 06107-2211
(239) 986-9398
Mailing address
93 LOCKWOOD DR, WATERTOWN, CT 06795-2511
(239) 986-9398
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/06/2017
Last updated
08/22/2023
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