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Individual
SHANNON M DILLON
Active
Individual
SHANNON M DILLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34004940A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000334950
ANTHEM BLUE CROSS
IN
01
—
357143
MHN
IN
Enumeration date
07/08/2005
Last updated
03/17/2009
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