Individual
MONIQUE SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1771 E FLAMINGO RD, LAS VEGAS, NV 89119-5155
(702) 560-2192
Mailing address
6500 W CHARLESTON BLVD APT 172, LAS VEGAS, NV 89146-9079
(725) 224-3904
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/10/2022
Last updated
06/10/2022
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