Individual
SHANNON TINNIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2257 ROAD 124, CHEYENNE, WY 82009-9173
(307) 286-0439
Mailing address
2257 ROAD 124, CHEYENNE, WY 82009-9173
(307) 286-0439
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
05/10/2011
Last updated
05/10/2011
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