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NPI Code Detail

MEDICARE: SHANNON DIERINGER

MEDICARE: SHANNON DIERINGER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1629595251
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON DIERINGER
Provider Business Mailing Address
First Line : 4105 N WALNUT ST
Second Line :
City : MUNCIE
State : IN
Zip : 47303-5904
Country : US
Telephone Number : 765-587-5244
Fax Number :
Provider Business Practice Location Address
First Line : 4105 N WALNUT ST
Second Line :
City : MUNCIE
State : IN
Zip : 47303-5904
Country : US
Telephone Number : 765-587-5244
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2017
Last Update Date : 07/21/2022

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Directions to “ SHANNON DIERINGER ” Practice Location

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