Individual
ASHLYNN LATRESE SHAMBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1460 NW VIVION RD, KANSAS CITY, MO 64118-4555
(816) 853-0946
(816) 396-8809
Mailing address
1460 NW VIVION RD, KANSAS CITY, MO 64118-4555
(816) 853-0946
(816) 396-8809
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBY-22-239039
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-22-239039
BEHAVIOR ANALYST CERTIFICATION BOARD
—
Enumeration date
10/25/2022
Last updated
10/25/2022
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