Provider Demographics
NPI:1942527163
Name:VAN DER SCHANS, SHANNA CHRISTINA (M ED BCBA)
Entity Type:Individual
Prefix:MRS
First Name:SHANNA
Middle Name:CHRISTINA
Last Name:VAN DER SCHANS
Suffix:
Gender:F
Credentials:M ED BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5162 IMOGENE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-2606
Mailing Address - Country:US
Mailing Address - Phone:281-468-3883
Mailing Address - Fax:
Practice Address - Street 1:5162 IMOGENE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-2606
Practice Address - Country:US
Practice Address - Phone:281-468-3883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-27
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-04-1752103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst