Shannon Tabaka, SW

NPI #1992680615 in Zimmerman, Minnesota

Provider Information

NPI Number: 1992680615
Entity Type: Individual
Name: Shannon Tabaka, SW
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Lodging
Credential: SW
Enumeration Date: Aug 11, 2025
Last Updated: Aug 11, 2025

Practice Location

Address: 12714 FREMONT AVE
City: Zimmerman
State: Minnesota
ZIP Code: 55398-9406
Phone: (763) 732-2065

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Lodging	177F00000X	Primary

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