Provider Demographics
NPI:1699048207
Name:HIRSCH, SHANNA E (MED, BCBA)
Entity type:Individual
Prefix:MRS
First Name:SHANNA
Middle Name:E
Last Name:HIRSCH
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5606 SHIELDS DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-3571
Mailing Address - Country:US
Mailing Address - Phone:301-493-0023
Mailing Address - Fax:
Practice Address - Street 1:5606 SHIELDS DR
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-3571
Practice Address - Country:US
Practice Address - Phone:301-493-0023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst