Provider Demographics
NPI:1821553868
Name:JOYNER, SHAVONNE D (BCABA, LABA)
Entity Type:Individual
Prefix:
First Name:SHAVONNE
Middle Name:D
Last Name:JOYNER
Suffix:
Gender:F
Credentials:BCABA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5306 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20187-9377
Mailing Address - Country:US
Mailing Address - Phone:571-212-6627
Mailing Address - Fax:
Practice Address - Street 1:5306 LEE HWY
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20187-9377
Practice Address - Country:US
Practice Address - Phone:571-212-6627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0134000235106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst