Individual
SHAUNA MERIDETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3085 S ST MIHIEL CIR, WASILLA, AK 99654-0282
(907) 841-3269
Mailing address
3085 S ST MIHIEL CIR, WASILLA, AK 99654-0282
(907) 841-3269
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
517612
AK
106S00000X
Behavior Technician
—
—
Other
Enumeration date
08/13/2019
Last updated
08/13/2019
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