Provider Demographics
NPI:1063164069
Name:PLAYER, SHAKILLA ELIZABETH (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:SHAKILLA
Middle Name:ELIZABETH
Last Name:PLAYER
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:SHAKILLA
Other - Middle Name:ELIZABETH
Other - Last Name:SPIVERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4302 CENTER ST APT Y101
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-8623
Mailing Address - Country:US
Mailing Address - Phone:206-822-1551
Mailing Address - Fax:
Practice Address - Street 1:19217 36TH AVE W STE 210
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5751
Practice Address - Country:US
Practice Address - Phone:425-977-3711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WABA61263426103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst