| NPI | 1598102774 |
|---|---|
| Former Name | SHANNON NICOLE MITCHELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ OPT-002530) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2346) |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2021-12-03 |