Provider Demographics
NPI:1225600257
Name:LAYMAN, SHANNON REBECCA (BCBA)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:REBECCA
Last Name:LAYMAN
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 1:297 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-5909
Mailing Address - Country:US
Mailing Address - Phone:502-807-5333
Mailing Address - Fax:
Practice Address - Street 1:297 CHERRY ST
Practice Address - Street 2:
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-5909
Practice Address - Country:US
Practice Address - Phone:502-807-5333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst