Corinna Shoemaker
Behavior Technician in Fort Wayne, IN. Individual provider (NPI-1).
NPI number1619704103
StatusActive
Last updated in NPPESSep 18, 2024
Details
- NPI
- 1619704103
- Entity type
- Individual (NPI-1)
- Name
- Corinna Shoemaker
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 18, 2024
- Certification date
- Sep 18, 2024
- Last updated
- Sep 18, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | RBT-24377031 | IN | Yes |
Practice location
5601 Coventry LnFort Wayne, IN 46804-7145
Phone 260-459-6040
Mailing address
5601 Coventry LnFort Wayne, IN 46804-7145
Phone 260-459-6040
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