Individual
SHANON HASKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1490 E BELTLINE AVE SE, GRAND RAPIDS, MI 49506-4336
(616) 940-0040
Mailing address
3320 PINE MEADOW DR SE, APT 103, KENTWOOD, MI 49512-3079
(616) 617-2622
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
56956
MI
Other
Enumeration date
02/03/2017
Last updated
02/03/2017
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