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General NPI Number Information
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NPI Number | 1619533130
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Entity Type | Individual
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Provider Name | SHANNON NICOLLE PARRINELLO
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Gender | Female
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Dates
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Enumeration Date | 05/10/2019
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Last Update Date | 10/30/2023
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Provider Practice Location Address
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Address Line | 1404 DEL PRADO BLVD S STE 135
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City | CAPE CORAL
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State | FL
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Zip | 33990-3782
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Country | US
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Telephone | 239-265-0586
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Fax |
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Provider Business Mailing Address
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Address Line | 3927 SW 17TH AVE
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City | CAPE CORAL
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State | FL
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Zip | 33914-5670
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Country | US
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Telephone | 239-265-0586
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IMH24291
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License Number State | FL
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