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1104364793
SHANON HASKINS
GRAND RAPIDS, MI
NPI
1104364793
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225800000X Recreation Therapist
(Licence: MI 56956)
Enumeration Date
2017-02-03
Last Update Date
2017-02-03
Business Address
-- SHANON HASKINS
1490 E BELTLINE AVE SE
GRAND RAPIDS, MI 49506-4336
Phone number: 616-940-0040
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Mailing Address
-- SHANON HASKINS
3320 PINE MEADOW DR SE APT 103
KENTWOOD, MI 49512-3079
Phone number: 616-617-2622
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