| NPI | 1831605765 |
|---|---|
| Other Name | SHANEQUIA NICKI CLEMONS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 175T00000X Peer Specialist | |
| 374K00000X Religious Nonmedical Practitioner | |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2022-08-29 |