Individual
SHANAN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9100 W 74TH ST, MERRIAM, KS 66204-4004
(913) 676-2253
Mailing address
1696 N 163RD ST, BASEHOR, KS 66007-9607
(913) 220-4532
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-474355
KS
Other
Enumeration date
09/22/2025
Last updated
09/22/2025
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