SHANNON DERICO

GARY, IN
NPI1548675739
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2014-06-25
Last Update Date2014-06-25
Business Address
-- SHANNON DERICO
1100 W 6TH AVE
GARY, IN 46402-1711
Phone number: 219-885-4264
Mailing Address
-- SHANNON DERICO
1100 W 6TH AVE
GARY, IN 46402-1711
Phone number: 219-885-4264
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