Individual
SHANNON MARIE TABLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3120 OLD FAITHFUL RD STE 100, CHEYENNE, WY 82001-5890
(307) 369-1410
Mailing address
3096 COLONIAL CIR, CRESTVIEW, FL 32539-8570
(617) 704-1639
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/26/2020
Last updated
02/26/2020
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