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1790273647
SHANNON D RUSSELL
EAST HARTFORD, CT
NPI
1790273647
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CT 6372)
Enumeration Date
2018-04-26
Last Update Date
2018-04-26
Business Address
SHANNON D RUSSELL
1406 MAIN ST
EAST HARTFORD, CT 06108-1684
Phone number: 860-249-0975
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Mailing Address
SHANNON D RUSSELL
1406 MAIN ST
EAST HARTFORD, CT 06108-1684
Phone number: 860-249-0975
Copy
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