Individual
SHANNON KAY CRASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 N MILES ST, ELIZABETHTOWN, KY 42701-1834
(270) 506-1325
Mailing address
21600 OXNARD ST, WOODLAND HILLS, CA 91367-4976
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
00005127
KY
Other
Enumeration date
01/19/2018
Last updated
01/19/2018
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