Individual
MRS. TIFFANY JO SHATTUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
332 S MICHIGAN AVE STE 900, CHICAGO, IL 60604-4393
(855) 832-6727
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-74967
IL
Other
Enumeration date
09/03/2024
Last updated
09/03/2024
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