NPI 1114432697

Shane G Walters, BCBA

Practitioner Behavior Analyst West Hartford, CT

Practice location

Address: 71 Raymond Rd, West Hartford, CT 06107-2211
Phone: (239) 986-9398
Mailing address: 93 Lockwood Dr, Watertown, CT 06795-2511

Registered specialties

Behavior Analyst Primary

Behavioral Health & Social Service Providers Taxonomy 103K00000X

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Registry record

NPI: 1114432697
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Dec 2017
Record last updated: 22 Aug 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.