| NPI | 1972661072 |
|---|---|
| Former Name | SHANNON MICHELLE BUCKLIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 385HR2055X Respite Care, Respite Care, Mental Illness, Child (Licence: AZ 9218) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2007-07-08 |