NPI 1821420639 · live from the CMS NPI Registry
Pamela Shackelford, BCBA
Behavior Analyst in Eagle River, AK. National Provider Identifier 1821420639, active.
NPI record
| NPI | 1821420639 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 11901 Business Blvd, Ste 209, Eagle River, AK 99577 |
| Practice phone | 907-694-6002 |
| Enumerated | August 2, 2013 |
| Last updated | August 2, 2013 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | 11313830 (AK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.