Individual
SHANNON DAWN KLASKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
5310 E WILLIAM STREET RD, DECATUR, IL 62521-1874
(217) 422-6361
Mailing address
24 FOREST KNOLLS EST, 24 SYCAMORE DRIVE, DECATUR, IL 62521-4422
(217) 422-6361
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-22439
IL
Other
Enumeration date
02/23/2016
Last updated
04/10/2018
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