Provider Demographics
NPI:1639835705
Name:SUNSHINE ABA THERAPY PLLC
Entity Type:Organization
Organization Name:SUNSHINE ABA THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, BCBA
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARADY
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:501-697-1768
Mailing Address - Street 1:30 ONYX DR
Mailing Address - Street 2:
Mailing Address - City:GREENBRIER
Mailing Address - State:AR
Mailing Address - Zip Code:72058-9148
Mailing Address - Country:US
Mailing Address - Phone:501-697-1768
Mailing Address - Fax:
Practice Address - Street 1:30 ONYX DR
Practice Address - Street 2:
Practice Address - City:GREENBRIER
Practice Address - State:AR
Practice Address - Zip Code:72058-9148
Practice Address - Country:US
Practice Address - Phone:501-697-1768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty