Dr. Derek Shanman, Ph.D.
Behavior Analyst in Thibodaux, LA. Individual provider (NPI-1).
NPI number1154778801
StatusActive
Last updated in NPPESMay 23, 2016
Details
- NPI
- 1154778801
- Entity type
- Individual (NPI-1)
- Name
- Dr. Derek Shanman
- Credential
- Ph.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 23, 2016
- Last updated
- May 23, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103K00000X | Behavior Analyst | L-103 | LA | Yes |
Practice location
311 Jackson StThibodaux, LA 70301-2621
Phone 985-492-1941
Mailing address
311 Jackson StThibodaux, LA 70301-2621
Phone 985-492-1941
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