Individual
SHANNON ELAINE MARINER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 2ND AVE SE, DES LACS, ND 58733-3633
(701) 818-8636
Mailing address
120 2ND AVE SE # 24, DES LACS, ND 58733-3633
(701) 818-8636
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
04/17/2026
Last updated
04/17/2026
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