| Shanon R. Pennington | |
|
125 Breakwater Bay Hermitage TN 37076-3675 | |
| (615) 414-8195 | |
| Not Available |
| Full Name | Shanon R. Pennington |
|---|---|
| Speciality | Behavior Analyst |
| Location | 125 Breakwater Bay, Hermitage, Tennessee |
| Authorized Official Name and Position | Shanon R Pennington (BCBA) |
| Authorized Official Contact | 6154148195 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shanon R. Pennington 125 Breakwater Bay Hermitage TN 37076-3675 Ph: (615) 414-8195 | Shanon R. Pennington 125 Breakwater Bay Hermitage TN 37076-3675 Ph: (615) 414-8195 |
| NPI Number | 1821515446 |
|---|---|
| Provider Enumeration Date | 08/24/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821515446 | NPI | - | NPPES |
| 1245788116 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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