Individual
CARSON ALEXANDER SHIGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6631 N WILLAMETTE BLVD UNIT B, PORTLAND, OR 97203-5677
(858) 900-1140
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/26/2024
Last updated
02/26/2024
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