Individual
CLARISSA NICOLE SHAKESPEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
59 FOX CHASE DR, ENTERPRISE, AL 36330-9339
(334) 778-2611
Mailing address
59 FOX CHASE DR, ENTERPRISE, AL 36330-9339
(334) 778-2611
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/21/2024
Last updated
05/21/2024
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