Provider Demographics
NPI:1366776528
Name:SHAPIRO, SANDRA (MS BCBA)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:MS BCBA
Other - Prefix:MS
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:GINDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS BCBA
Mailing Address - Street 1:2675 RAINIER CT NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-3358
Mailing Address - Country:US
Mailing Address - Phone:321-258-0148
Mailing Address - Fax:
Practice Address - Street 1:2675 RAINIER CT NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-3358
Practice Address - Country:US
Practice Address - Phone:321-258-0148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-07-3528103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst