Wagner, Shannon Lee

Wagner, Shannon Lee is an individual health care provider with primary practice located at 203 Union St , Manchester CT 06042-1938. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Wagner, Shannon Lee can be contacted via phone (860) 455-3629.

Contact Information

Primary practice address
203 Union St Manchester CT 06042-1938
Phone: (860) 455-3629
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1225686538
LBN Legal business name Wagner, Shannon Lee
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2019
Last updated Aug 29th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers