Provider Demographics
NPI:1023893211
Name:SHRIVER, SHAYNA (BCBA, LBA, ED DIAG)
Entity type:Individual
Prefix:DR
First Name:SHAYNA
Middle Name:
Last Name:SHRIVER
Suffix:
Gender:F
Credentials:BCBA, LBA, ED DIAG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1859 LAUREL MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:BELINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:26250-1108
Mailing Address - Country:US
Mailing Address - Phone:573-378-0708
Mailing Address - Fax:
Practice Address - Street 1:1859 LAUREL MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:BELINGTON
Practice Address - State:WV
Practice Address - Zip Code:26250-1108
Practice Address - Country:US
Practice Address - Phone:573-378-0708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst