Individual
MR. SHAYNE RYAN BEATTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
3401 COLONIAL DR, COLUMBIA, SC 29203-6934
(803) 394-5619
(803) 339-1907
Mailing address
3401 COLONIAL DR, COLUMBIA, SC 29203-6934
(803) 394-5619
(803) 339-1907
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102909247
DL#
SC
Enumeration date
04/01/2021
Last updated
04/01/2021
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