Individual
MRS. ATTALAYA L SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6140 W EXECUTIVE DR STE B, MEQUON, WI 53092-4499
(888) 754-0398
Mailing address
11525 N OAKVIEW CT, MEQUON, WI 53092-4381
(262) 825-0694
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
WI
Other
Enumeration date
03/25/2025
Last updated
03/25/2025
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