Madison Shannon

NPI #1215626148 in Hugo, Minnesota

Provider Information

NPI Number: 1215626148
Entity Type: Individual
Name: Madison Shannon
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: May 5, 2023
Last Updated: May 5, 2023

Practice Location

Address: 14663 MERCANTILE DR N
City: Hugo
State: Minnesota
ZIP Code: 55038-4559
Phone: (612) 405-3156

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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