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1659052660
HEATHER L SHANNON
MOSCOW, ID
NPI
1659052660
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ID LMSW-39251)
Enumeration Date
2023-07-31
Last Update Date
2024-07-01
Business Address
HEATHER L SHANNON LMSW
803 S MAIN ST STE 120
MOSCOW, ID 83843-2695
Phone number: 208-848-8300
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Mailing Address
HEATHER L SHANNON LMSW
130 SPRUCE ST
POTLATCH, ID 83855-5006
Phone number: 714-625-5546
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