Shannon Danielle Roth

NPI #1962085043 in Fort Collins, Colorado

Provider Information

NPI Number: 1962085043
Entity Type: Individual
Name: Shannon Danielle Roth
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: May 5, 2021
Last Updated: May 5, 2021

Practice Location

Address: 303 W PROSPECT RD UNIT 106
City: Fort Collins
State: Colorado
ZIP Code: 80526-2148
Phone: (443) 458-8194

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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