Shannon Smith
Behavior Technician in Bloomington, IN. Individual provider (NPI-1).
NPI number1609598317
StatusActive
Last updated in NPPESSep 19, 2022
Details
- NPI
- 1609598317
- Entity type
- Individual (NPI-1)
- Name
- Shannon Smith
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 19, 2022
- Certification date
- Sep 19, 2022
- Last updated
- Sep 19, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | RBT-22-226845 | IN | Yes |
Practice location
227 W Grimes LnBloomington, IN 47403-3015
Phone 812-322-0313
Mailing address
Po Box 668Bloomington, IN 47402-0668
Phone 812-322-0313
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