Individual
SHANNICK ANNAI MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13116 SOLAR BAY LN, VICTORVILLE, CA 92394-9523
(951) 281-9704
Mailing address
13116 SOLAR BAY LN, VICTORVILLE, CA 92394-9523
(951) 281-9704
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
6874
CA
Other
Enumeration date
10/10/2021
Last updated
10/10/2021
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