Most Relevant Information
Provider Data
| NPI Number: | 1003034901 |
| Provider Name: | SHANNON J MITCHELL |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: | 2014000839 |
Most Important Dates
| Enumeration Date: | 04/23/2007 |
| Last Updated: | 01/16/2014 |
Provider Practice Location
10 CHARTRES CT
LAKE ST LOUIS
MO
633671230
Practice Location Phone/Fax
| Phone: | 6183228746 |
| Fax: |
Provider Mailing Location
10 CHARTRES CT
LAKE ST LOUIS
MO
633671230
Provider Mailing Phone/Fax
| Phone: | 6183228746 |
| Fax: |