SHANNON RUSSELL

DAYTON, OH
NPI1790250504
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy3747P1801X Technician, Personal Care Attendant
Additional Taxonomies171M00000X Case Manager/Care Coordinator
(Licence: OH  CDCA.165915)
Enumeration Date2018-10-08
Last Update Date2024-07-25
Business Address
SHANNON RUSSELL QMHS/CDCA
5244 W 2ND ST
DAYTON, OH 45417-9044
Phone number: 937-369-9916
Mailing Address
SHANNON RUSSELL QMHS/CDCA
5244 W 2ND ST
DAYTON, OH 45417-9044
Phone number: 937-369-9916