Individual
MS. VANESSA MICHELE SHABANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6905 E STATE ST, ROCKFORD, IL 61108-2692
(815) 397-4142
Mailing address
6905 E STATE ST, ROCKFORD, IL 61108-2692
(815) 397-4142
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
11/09/2012
Last updated
11/09/2012
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