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Individual

REX CHARLES SHANGRAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BCBA

Contact information

Practice address
540 W INTERNATIONAL AIRPORT RD, ANCHORAGE, AK 99518-1105
(907) 433-4789
Mailing address
8130 PECK AVE, ANCHORAGE, AK 99504-1422
(907) 444-5931

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
106S00000X
Behavior Technician

Other

Enumeration date
10/30/2010
Last updated
06/09/2022
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