| NPI | 1003301243 |
|---|---|
| Former Name | SHAWNA MAE VANCIU |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN 3342) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: MN RBT-16-19532) |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2022-06-06 |