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1073649919
SHANNON JANE HENDRICKSON
MEDFORD, MA
NPI
1073649919
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
(Licence: MA 110897)
Enumeration Date
2007-02-26
Last Update Date
2009-10-05
Business Address
-- SHANNON JANE HENDRICKSON PMHCNS,BC
151 MYSTIC AVE
MEDFORD, MA 02155-4632
Phone number: 781-396-1199
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Mailing Address
-- SHANNON JANE HENDRICKSON PMHCNS,BC
151 MYSTIC AVE
MEDFORD, MA 02155-4632
Phone number: 781-396-1199
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