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1295963809
SHANNON WOODERSON
GRASS VALLEY, CA
NPI
1295963809
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
322D00000X Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date
2009-06-23
Last Update Date
2009-06-23
Business Address
-- SHANNON WOODERSON
714 W MAIN ST
GRASS VALLEY, CA 95945-6410
Phone number: 530-477-9800
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Mailing Address
-- SHANNON WOODERSON
714 W MAIN ST
GRASS VALLEY, CA 95945-6410
Phone number: 530-477-9800
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