Individual
SHANNA LEE PEGUERO GARCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
916 STELLER WAY, KODIAK, AK 99615-6490
(907) 942-1294
Mailing address
PO BOX 147, KODIAK, AK 99615-0147
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/23/2023
Last updated
06/23/2023
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