Most Relevant Information
Provider Data
| NPI Number: | 1003347030 |
| Provider Name: | SHANYN HANSEN |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | BACB291360 |
Most Important Dates
| Enumeration Date: | 03/22/2017 |
| Last Updated: | 03/22/2017 |
Provider Practice Location
296 COALING RD
TROUTVILLE
VA
241756413
Practice Location Phone/Fax
| Phone: | 5403126057 |
| Fax: |
Provider Mailing Location
296 COALING RD
TROUTVILLE
VA
241756413
Provider Mailing Phone/Fax
| Phone: | 5403126057 |
| Fax: |