Individual
SHANE FRIEND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2808 S PICHER AVE, JOPLIN, MO 64804-1645
(417) 347-7850
Mailing address
PO BOX 2526, JOPLIN, MO 64803-2526
(417) 347-7579
(417) 347-0293
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
2017037743
MO
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
01/21/2016
Last updated
12/28/2017
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