Individual
MS. SHANNON LEANN BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
150 SHOUP AVENUE, IDAHO FALLS, ID 83402
(208) 528-4062
(208) 528-4076
Mailing address
150 SHOUP AVENUE, IDAHO FALLS, ID 83402
(208) 528-4062
(208) 528-4076
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
07/21/2022
Last updated
07/21/2022
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