Jacqualyn D Shannon
Jacqualyn D Shannon is a Developmental Therapist in Bowling Green, Kentucky. Practices as a sole proprietor. Licensed in Kentucky.
- Licensed in
- KY
- In the registry since
- 2025
Practice location Address checks out
325 Audley Ave Apt 4Bowling Green, KY 42101-4489
Phone: (615) 423-5017
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Specialties & licences
| Developmental Therapist (primary) | Taxonomy 222Q00000X · Licence 201237255 (KY) |
|---|
Record details
| NPI number | 1114731403 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | February 5, 2025 |
| Last updated in NPPES | February 5, 2025 |
| Certification date | February 5, 2025 |
| Mailing address | 325 Audley Ave Apt 4, Bowling Green, KY 42101-4489 |
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