Shannon Lee Blain

NPI #1811618168 in Viera, Florida

Provider Information

NPI Number: 1811618168
Entity Type: Individual
Name: Shannon Lee Blain
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Sep 6, 2022
Last Updated: Sep 6, 2022

Practice Location

Address: 5500 MURRELL RD STE 100
City: Viera
State: Florida
ZIP Code: 32940-6700
Phone: (321) 426-7759

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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