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NPI Code Detail

MEDICARE: SHANELL MONEGHAN

MEDICARE: SHANELL MONEGHAN
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 : 1861816480
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANELL MONEGHAN
Provider Business Mailing Address
First Line : 6714 WINKLER RD
Second Line :
City : FORT MYERS
State : FL
Zip : 33919-7204
Country : US
Telephone Number : 239-245-8301
Fax Number : 239-245-8731
Provider Business Practice Location Address
First Line : 6714 WINKLER RD
Second Line :
City : FORT MYERS
State : FL
Zip : 33919-7204
Country : US
Telephone Number : 239-245-8301
Fax Number : 239-245-8731
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2014
Last Update Date : 02/18/2014

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Directions to “ SHANELL MONEGHAN ” Practice Location

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