Individual
SHANNON WELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LBA, BCBA
Contact information
Practice address
5025 E WASHINGTON ST STE 212, PHOENIX, AZ 85034-7439
(602) 773-5775
Mailing address
4231 N 27TH ST APT 11, PHOENIX, AZ 85016-5742
(847) 508-4347
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
06/23/2020
Last updated
06/23/2020
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