Provider Demographics
NPI:1871292094
Name:SHY, RHONDA (BEHAVIOR TECHNICIAN)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:SHY
Suffix:
Gender:F
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:
Other - Last Name:SHY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BEHAVIOR TECHNICIAN
Mailing Address - Street 1:24280 E 950 RD
Mailing Address - Street 2:
Mailing Address - City:HYDRO
Mailing Address - State:OK
Mailing Address - Zip Code:73048-9645
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2121 E MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-6030
Practice Address - Country:US
Practice Address - Phone:405-857-8280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No175T00000XOther Service ProvidersPeer Specialist