Healthcare Provider Details

I. General information

NPI: 1598670630
Provider Name (Legal Business Name): SHANNON STRICKLAND II
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 E OAKLAND AVE
MONTICELLO AR
71655-5809
US

IV. Provider business mailing address

919 E OAKLAND AVE
MONTICELLO AR
71655-5809
US

V. Phone/Fax

Practice location:
  • Phone: 870-460-5667
  • Fax:
Mailing address:
  • Phone: 870-460-5667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: