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1740064229
SHANNON WALLACE OTTENS
SEBASTOPOL, CA
NPI
1740064229
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CA 117344)
Enumeration Date
2023-08-24
Last Update Date
2023-08-24
Business Address
SHANNON WALLACE OTTENS ACSW
652 PETALUMA AVE STE H
SEBASTOPOL, CA 95472-4266
Phone number: 707-823-3166
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Mailing Address
SHANNON WALLACE OTTENS ACSW
PO BOX 8531
SANTA ROSA, CA 95407-1531
Phone number:
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