Provider Demographics
NPI:1326509100
Name:REINEKE, SHELBY LYNN (M ED, BCBA)
Entity Type:Individual
Prefix:MS
First Name:SHELBY
Middle Name:LYNN
Last Name:REINEKE
Suffix:
Gender:F
Credentials:M ED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 RIVER VIEW AVE APT 85
Mailing Address - Street 2:
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-5149
Mailing Address - Country:US
Mailing Address - Phone:715-347-2604
Mailing Address - Fax:
Practice Address - Street 1:5225 HEFFRON CT
Practice Address - Street 2:
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-5086
Practice Address - Country:US
Practice Address - Phone:715-544-6847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst