Doctor Name: | MS. MARQUISA DANAE SHANNON |
NPI Number: | 1568615888 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | B.A,M.B.A |
License Number: | 6803085735 |
Business Practice Address: | 4875 Coplin St Detroit, MI - 482152192 |
Business Phone Number: | 3138221135 |
Business Fax Number: | 3138221157 |
Mailing Address: | 274 Lakewood St, DETROIT |
State: | MI |
Postal Code: | 482153152 |
Phone Number: | 3138227986 |
Fax Number: | |
NPI Enumeration Date: | 10/30/2008 |
NPI Last Update Date: | 10/30/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 247200000X |
License Number: | 6803085735 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Technician, Other |
Taxonomy Specialization: | |
Taxonomy Definition: | A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user. |