Individual
SKYLARR RAQUEL SHURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA, LBA
Contact information
Practice address
2001 N 3RD ST STE 100, PHOENIX, AZ 85004-1495
(602) 922-6760
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BEH-000936
AZ
103K00000X
Behavior Analyst
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—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-21-54683
BCBA CERTIFICATE
—
Enumeration date
02/04/2022
Last updated
12/08/2023
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