Provider Demographics
NPI:1922349216
Name:SHEN, YINGCHUN (MS)
Entity Type:Individual
Prefix:MISS
First Name:YINGCHUN
Middle Name:
Last Name:SHEN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 SIERRA CIR
Mailing Address - Street 2:APT G
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3717
Mailing Address - Country:US
Mailing Address - Phone:610-930-8806
Mailing Address - Fax:
Practice Address - Street 1:145 FAUNCE CORNER RD
Practice Address - Street 2:SUITE K
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-1263
Practice Address - Country:US
Practice Address - Phone:610-930-8806
Practice Address - Fax:774-206-1125
Is Sole Proprietor?:No
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-13-12969 (BCBA)103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst