Individual
SHAWN J MACDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
819 TARA PLZ, PAPILLION, NE 68046-2043
(907) 206-4450
Mailing address
819 TARA PLZ, PAPILLION, NE 68046-2043
(907) 206-4450
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-214746
MN
Other
Enumeration date
07/23/2019
Last updated
10/13/2023
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