Provider Demographics
NPI:1447498795
Name:GUNTER, SHANNON RENEE (BCABA)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:RENEE
Last Name:GUNTER
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5010 SE 30TH CT
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34480-8421
Mailing Address - Country:US
Mailing Address - Phone:352-425-0385
Mailing Address - Fax:352-867-1557
Practice Address - Street 1:5010 SE 30TH CT
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34480-8421
Practice Address - Country:US
Practice Address - Phone:352-425-0385
Practice Address - Fax:352-867-1557
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-25
Last Update Date:2009-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst