Provider Demographics
NPI:1730793076
Name:LEINWEBER, SHELBY (BCBA)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:LEINWEBER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 E UNION HILLS DR APT 1083
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-3366
Mailing Address - Country:US
Mailing Address - Phone:480-289-8020
Mailing Address - Fax:
Practice Address - Street 1:2095 W PINNACLE PEAK RD STE 110B
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-1247
Practice Address - Country:US
Practice Address - Phone:623-209-8521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst