Individual
ANTONINA IVANOVNA SHANGRAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, BCBA-D
Contact information
Practice address
23 S BEECH ST # B102, CORTEZ, CO 81321-3751
(970) 946-1539
Mailing address
23 S BEECH ST # B102, CORTEZ, CO 81321-3751
(970) 946-1539
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/06/2012
Last updated
11/03/2021
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