Individual
SHAINA DESTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
62 BLUFF VIEW DR, RINGGOLD, GA 30736-2558
(423) 475-3517
Mailing address
2270 THORNTON TAYLOR PKWY STE B, FAYETTEVILLE, TN 37334-3669
(615) 669-6397
(615) 992-3933
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-64211
TN
Other
Enumeration date
03/21/2023
Last updated
03/27/2025
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