Most Relevant Information
Provider Data
| NPI Number: | 1003420241 |
| Provider Name: | SHANNON CALISE BCBA |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: | 12043457 |
Most Important Dates
| Enumeration Date: | 09/04/2020 |
| Last Updated: | 09/23/2024 |
Provider Practice Location
802 FEDERAL RD
BROOKFIELD
CT
068044008
Practice Location Phone/Fax
| Phone: | 2032447435 |
| Fax: |
Provider Mailing Location
32 WALKER RD
HOPEWELL JUNCTION
NY
125335527
Provider Mailing Phone/Fax
| Phone: | 9146453842 |
| Fax: |