Provider Demographics
NPI:1679280440
Name:DELAO- WALKER, SHAWNACY UNIQUE (RBT)
Entity Type:Individual
Prefix:MRS
First Name:SHAWNACY
Middle Name:UNIQUE
Last Name:DELAO- WALKER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 BRETT DR APT 113
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-4241
Mailing Address - Country:US
Mailing Address - Phone:281-839-0556
Mailing Address - Fax:
Practice Address - Street 1:910 BRETT DR APT 113
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-4241
Practice Address - Country:US
Practice Address - Phone:281-839-0556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARBT-22-236794106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician