Provider Demographics
NPI:1750896122
Name:FINOS, SHAWNA NIKOLE
Entity type:Individual
Prefix:
First Name:SHAWNA
Middle Name:NIKOLE
Last Name:FINOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 TERRACE ST STE 201
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49440-1107
Mailing Address - Country:US
Mailing Address - Phone:616-942-2110
Mailing Address - Fax:
Practice Address - Street 1:715 TERRACE ST STE 201241
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49440-1105
Practice Address - Country:US
Practice Address - Phone:231-830-7376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-07
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
MI0-19-9935106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician