Provider Demographics
NPI:1720805377
Name:HENSCHEL, SHAUNA RENE FOY (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:SHAUNA
Middle Name:RENE FOY
Last Name:HENSCHEL
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3564 ROUTE 82
Mailing Address - Street 2:
Mailing Address - City:MILLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:12545-6033
Mailing Address - Country:US
Mailing Address - Phone:845-546-2198
Mailing Address - Fax:
Practice Address - Street 1:61 COOPER HILL RD
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-5903
Practice Address - Country:US
Practice Address - Phone:203-424-1133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1889103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst