| NPI | 1548592512 |
|---|---|
| Former Name | SHANNON KATHLEEN MARIE AMMONS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA LICSW1141006) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OK 5452) |
| Enumeration Date | 2010-02-02 |
| Last Update Date | 2025-05-08 |