Individual
SHAYNA NICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
40 PINE RIDGE LN, TRENTON, ME 04605-6546
(207) 317-6546
Mailing address
40 PINE RIDGE LN, TRENTON, ME 04605-6546
(207) 317-6546
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-08-4870
—
Other
Enumeration date
07/21/2014
Last updated
07/21/2014
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