Basic Information
| Provider Information | |||||||||
| NPI: | 1073972923 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PIEHOTA | ||||||||
| FirstName: | SHEENA | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | BCBA, QBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4234 COUGAR CIR | ||||||||
| Address2: | |||||||||
| City: | NICEVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 325788784 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3867179131 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 169 MITTIE HADDOCK DR | ||||||||
| Address2: | |||||||||
| City: | CAMERON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283269379 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3867179131 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2016 | ||||||||
| LastUpdateDate: | 02/23/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 1-21-55111 | FL | Y | Behavioral Health & Social Service Providers | Behavioral Analyst | 103K00000X | 11273 | NC | N | Behavioral Health & Social Service Providers | Behavioral Analyst | 103K00000X | 8013 | NC | N | Behavioral Health & Social Service Providers | Behavioral Analyst | 106E00000X | N |
No ID Information.