NPI 1083344246

Marisa Luellamae Shackleford

Practitioner Behavior Analyst Faribault, MN

Practice location

Address: 218 Central Ave N, Faribault, MN 55021-5278
Phone: (507) 491-5475

Registered specialties

Behavior Analyst Primary

Behavioral Health & Social Service Providers Taxonomy 103K00000X

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Registry record

NPI: 1083344246
Entity type: Individual
Sex (as registered): Female
NPI issued: 12 Jun 2022
Record last updated: 12 Jun 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.