Individual provider · Type 1 NPI

Jacqualyn D. Shannon

Developmental Therapist · Bowling Green, KY

NPI number 1114731403 Active

Practice location

325 Audley Ave Apt 4
Bowling Green, KY 42101-4489

Call (615) 423-5017 Map

Specialties and licenses

TaxonomyCodeLicense
Developmental Therapist Primary 222Q00000X201237255 (KY)

Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…

Other developmental therapist providers in Bowling Green

See all in Bowling Green →

About NPI 1114731403

Jacqualyn D. Shannon's National Provider Identifier is 1114731403, issued on Feb 5, 2025. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in Bowling Green, KY. The record was last updated on Feb 5, 2025.