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1215608252
JUSTIN SHANNON
LAKEWOOD, WA
NPI
1215608252
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2021-09-21
Last Update Date
2021-09-21
Business Address
JUSTIN SHANNON
10015 LAKEWOOD DR SW
LAKEWOOD, WA 98499-3838
Phone number: 855-223-7123
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Mailing Address
JUSTIN SHANNON
16782 VON KARMAN AVE STE 11
IRVINE, CA 92606-2417
Phone number: 855-223-7123
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