Organization
SHINING PATHWAY ABA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTWAN EVANS (OWNER)
(269) 861-5506
Entity
Organization
Contact information
Practice address
10215 BELLINGHAM DR, SUMMERSET, SD 57718-9271
(269) 861-5506
Mailing address
10215 BELLINGHAM DR, SUMMERSET, SD 57718-9271
(269) 861-5506
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
08/28/2024
Last updated
08/28/2024
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