Individual
KAYTLYN PAIGE SHADISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
2500 BROOKTREE RD STE 101, WEXFORD, PA 15090-9278
(412) 301-6204
Mailing address
504 EUCLID AVE, CANONSBURG, PA 15317-2044
(724) 271-8416
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-222726
IN
Other
Enumeration date
06/19/2024
Last updated
06/19/2024
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