Individual
EMILY SHADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1330 QUAIL LAKE LOOP, SUITE 120, COLORADO SPRINGS, CO 80906-4651
(855) 223-7123
(619) 374-7134
Mailing address
16782 VON KARMAN AVE STE 11, IRVINE, CA 92606-2417
(855) 223-7123
(619) 374-7134
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-24304
CO
106E00000X
Assistant Behavior Analyst
0-14-6129
CO
Other
Enumeration date
10/29/2014
Last updated
12/08/2017
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