Provider Demographics
NPI:1598257008
Name:MARKLAND, SHAWNEE MAE KAY (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:SHAWNEE
Middle Name:MAE KAY
Last Name:MARKLAND
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 1:230 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ERWIN
Mailing Address - State:TN
Mailing Address - Zip Code:37650-1206
Mailing Address - Country:US
Mailing Address - Phone:423-331-9923
Mailing Address - Fax:
Practice Address - Street 1:230 1ST ST
Practice Address - Street 2:
Practice Address - City:ERWIN
Practice Address - State:TN
Practice Address - Zip Code:37650-1206
Practice Address - Country:US
Practice Address - Phone:423-331-9923
Practice Address - Fax:423-373-1554
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
1-18-31256103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ046140Medicaid