Provider Demographics
NPI:1932946100
Name:STEWART, SHAYLA (MA, BCBA)
Entity type:Individual
Prefix:
First Name:SHAYLA
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3309 CHANEY CIR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30506-3719
Mailing Address - Country:US
Mailing Address - Phone:706-949-2445
Mailing Address - Fax:
Practice Address - Street 1:2360 MURPHY BLVD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30504-6002
Practice Address - Country:US
Practice Address - Phone:770-535-8372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-13
Last Update Date:2024-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst