| NPI | 1457959777 |
|---|---|
| Former Name | SHANNON MARIE WHITE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CT 004405) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 085109) |
| Enumeration Date | 2020-10-09 |
| Last Update Date | 2023-11-20 |