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1699055673
SHANNON G. CONVERSE
MODESTO, CA
NPI
1699055673
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
Enumeration Date
2011-08-23
Last Update Date
2011-08-23
Business Address
-- SHANNON G. CONVERSE
610 14TH ST
MODESTO, CA 95354-2505
Phone number: 209-524-4858
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Mailing Address
-- SHANNON G. CONVERSE
4208 FARA BIUNDO DR
MODESTO, CA 95355-9794
Phone number: 209-526-5019
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