| NPI | 1386096790 |
|---|---|
| Former Name | SHANNON FLEETWOOD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS 07235) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 10002) |
| 104100000X Social Worker (Licence: MO 2016027520) | |
| Enumeration Date | 2016-07-09 |
| Last Update Date | 2026-06-16 |