Provider Demographics
NPI:1609760982
Name:ROBERTSON, SHAYLA (RBT)
Entity type:Individual
Prefix:
First Name:SHAYLA
Middle Name:
Last Name:ROBERTSON
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 1:175 BELGROVE DR
Mailing Address - Street 2:
Mailing Address - City:KEARNY
Mailing Address - State:NJ
Mailing Address - Zip Code:07032-1507
Mailing Address - Country:US
Mailing Address - Phone:201-979-1336
Mailing Address - Fax:
Practice Address - Street 1:500 REDLAND CT STE 102
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-3265
Practice Address - Country:US
Practice Address - Phone:201-979-1336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician