Provider Demographics
NPI:1093383317
Name:BUSBY, SHAINA LEIGH (RBT)
Entity Type:Individual
Prefix:
First Name:SHAINA
Middle Name:LEIGH
Last Name:BUSBY
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6479 CAROLINE ST FL 32570
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-4502
Mailing Address - Country:US
Mailing Address - Phone:860-607-6910
Mailing Address - Fax:
Practice Address - Street 1:6479 CAROLINE ST FL 32570
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-4502
Practice Address - Country:US
Practice Address - Phone:860-607-6910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-171757106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician