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Individual
KATHLEEN MARIE SHANNON
Active
Individual
KATHLEEN MARIE SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
I.0003968-SUPV
OH
104100000X
Social Worker
I0003968
OH
Other
Enumeration date
09/22/2006
Last updated
09/03/2020
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