Individual
SHANOAH WHITMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
62 PROVIDENCE PIKE STE E, PUTNAM, CT 06260-2415
(818) 241-6780
Mailing address
1055 E COLORADO BLVD, PASADENA, CA 91106-2327
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/08/2019
Last updated
07/08/2019
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