Individual
SHANNON MARIE COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5304 GRAND AVE, WESTERN SPRINGS, IL 60558-1838
(715) 497-4416
Mailing address
5304 GRAND AVE, WESTERN SPRINGS, IL 60558-1838
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
C452-7939-1872
IL
Other
Enumeration date
10/28/2016
Last updated
10/28/2016
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