Individual
SHANNON LY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
39 TANNERY RD, DILLSBURG, PA 17019-9673
(844) 588-4222
Mailing address
275 CUMBERLAND PKWY STE 316, MECHANICSBURG, PA 17055-5677
(844) 588-4222
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-36323
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-17-36323
APPLIED BEHAVIOR ANALYSIS - REGISTERED BEHAVIOR TECHNICIAN
PA
Enumeration date
01/25/2018
Last updated
04/09/2021
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