Organization
SHANON R. PENNINGTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANON R PENNINGTON M.A., BCBA (BCBA)
(615) 414-8195
Entity
Organization
Contact information
Practice address
125 BREAKWATER BAY, HERMITAGE, TN 37076-3675
(615) 414-8195
Mailing address
125 BREAKWATER BAY, HERMITAGE, TN 37076-3675
(615) 414-8195
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245788116
—
TN
Enumeration date
08/24/2017
Last updated
07/21/2022
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