Provider Demographics
NPI:1255848412
Name:DOWNING, SHANELLE D
Entity Type:Individual
Prefix:MRS
First Name:SHANELLE
Middle Name:D
Last Name:DOWNING
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SHANELLE
Other - Middle Name:D
Other - Last Name:WHETSTONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:312 MARSHALL AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4840
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:312 MARSHALL AVE STE 102
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4840
Practice Address - Country:US
Practice Address - Phone:240-297-3550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106E00000X
MD1-18-31143103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst