| NPI | 1013458660 |
|---|---|
| Former Name | SHANNON N FABRE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: ID MASG1964) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA60169177) |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2017-03-15 |