Provider Demographics
NPI:1073972923
Name:PIEHOTA, SHEENA M (BCBA, QBA)
Entity Type:Individual
Prefix:DR
First Name:SHEENA
Middle Name:M
Last Name:PIEHOTA
Suffix:
Gender:F
Credentials:BCBA, QBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4234 COUGAR CIR
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-8784
Mailing Address - Country:US
Mailing Address - Phone:386-717-9131
Mailing Address - Fax:
Practice Address - Street 1:169 MITTIE HADDOCK DR
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:NC
Practice Address - Zip Code:28326-9379
Practice Address - Country:US
Practice Address - Phone:386-717-9131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-21
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-21-55111103K00000X
NC11273103K00000X
NC8013103K00000X
106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst