Provider Demographics
NPI:1760797286
Name:SHAYNE, RACHEL K (BCBA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:K
Last Name:SHAYNE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:K
Other - Last Name:GRAVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:1004 HICKORY HILL LANE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076
Mailing Address - Country:US
Mailing Address - Phone:615-902-0950
Mailing Address - Fax:615-902-0951
Practice Address - Street 1:1004 HICKORY HILL LANE
Practice Address - Street 2:SUITE 2
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076
Practice Address - Country:US
Practice Address - Phone:615-902-0950
Practice Address - Fax:615-902-0951
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-09
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist