Individual
JADA SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1030 BAILES RIDGE AVE APT 306, FORT MILL, SC 29707-0163
(803) 246-7025
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
(855) 832-6727
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/25/2022
Last updated
07/25/2022
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