Individual
SHANNON BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED, BCBA
Contact information
Practice address
120 BYRON AVE, ALTOONA, PA 16602-4106
(814) 201-2773
Mailing address
6660 E 950 S, HUNTSVILLE, UT 84317-9726
(801) 391-8970
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-33764
—
106S00000X
Behavior Technician
RBT-15-06331
UT
Other
Enumeration date
12/02/2016
Last updated
04/12/2019
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