Individual
DR. KENNETH DOUGLAS SHAMLIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD, BCBA-D
Contact information
Practice address
3775 45TH AVE, COLUMBUS, NE 68601-4427
(402) 564-7200
(402) 559-5737
Mailing address
985450 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-5450
(402) 559-6408
(402) 559-5737
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-10-7098
—
103T00000X
Psychologist
21219
NY
103T00000X
Psychologist
Primary
856
NE
Other
Enumeration date
05/12/2010
Last updated
06/28/2023
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