| NPI | 1104144286 |
|---|---|
| Former Name | SHANNON ASHLEY HALABOV |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 216685) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2011-06-17 |