Individual
MRS. SHANNON LEIGH TYNER THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
751 E. GEORGIA STREET, WOODRUFF, SC 29388
(864) 476-7400
Mailing address
751 E. GEORGIA STREET, WOODRUFF, SC 29388
(864) 476-7400
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-21211
SC
Other
Enumeration date
01/12/2016
Last updated
04/15/2019
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