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Individual
NANCY SHANNON
Active
Individual
NANCY SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
I0004427
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000142646
ANTHEM
OH
Enumeration date
09/01/2005
Last updated
03/19/2009
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