Park, Shane Byron

Park, Shane Byron is an sole proprietor health care provider with primary practice located at 5500 W Bagley Park Rd , West Jordan UT 84081-5697. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as his primary health care specialty. Park, Shane Byron can be contacted via phone (702) 917-4192.

Contact Information

Primary practice address
5500 W Bagley Park Rd West Jordan UT 84081-5697
Phone: (702) 917-4192
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X

Profile Details

NPI number 1265850143
LBN Legal business name Park, Shane Byron
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 28th, 2014
Last updated Mar 28th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers