Most Relevant Information
Provider Data
| NPI Number: | 1003546672 |
| Provider Name: | SHANNON KAMINSKI |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-22-220036 |
Most Important Dates
| Enumeration Date: | 06/15/2022 |
| Last Updated: | 06/15/2022 |
Provider Practice Location
606 E BALTIMORE PIKE FL 2
MEDIA
PA
190631751
Practice Location Phone/Fax
| Phone: | 6108647376 |
| Fax: | 8775993340 |
Provider Mailing Location
PO BOX 631280
CINCINNATI
OH
452631280
Provider Mailing Phone/Fax
| Phone: | 6108647376 |
| Fax: | 8775993340 |