Individual
SHANNON PRIDDY-MARIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., BCBA, LBA
Contact information
Practice address
228 EMMANUEL WAY LN, WEBSTER, KY 40176-5037
(310) 560-9270
Mailing address
228 EMMANUEL WAY LN, WEBSTER, KY 40176-5037
(310) 560-9270
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0064
KY
Other
Enumeration date
10/27/2010
Last updated
02/24/2014
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