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1922883016
SHANNAN JEROME
MERRILLVILLE, IN
NPI
1922883016
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
(Licence: IN 23-286442)
Enumeration Date
2023-08-28
Last Update Date
2023-08-28
Business Address
SHANNAN JEROME RBT
8200 GEORGIA ST
MERRILLVILLE, IN 46410-6227
Phone number: 219-791-1400
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Mailing Address
SHANNAN JEROME RBT
8200 GEORGIA ST
MERRILLVILLE, IN 46410-6227
Phone number: 219-791-1400
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