Individual
SHAWNA WORRALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
629 PAWNEE ST, LEAVENWORTH, KS 66048-1447
(785) 256-9096
Mailing address
629 PAWNEE ST, LEAVENWORTH, KS 66048-1447
(785) 256-9096
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-184301
KS
Other
Enumeration date
09/10/2021
Last updated
09/10/2021
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