Provider Demographics
NPI:1366790701
Name:QUIGLEY, SHAWN PATRICK SR (PHD BCBA-D)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:PATRICK
Last Name:QUIGLEY
Suffix:SR
Gender:M
Credentials:PHD BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 SIERRA NORTE LOOP NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-2514
Mailing Address - Country:US
Mailing Address - Phone:208-760-7346
Mailing Address - Fax:
Practice Address - Street 1:1900 SIERRA NORTE LOOP NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144-2514
Practice Address - Country:US
Practice Address - Phone:208-760-7346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst