Individual
EMMA FAYE SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
1502 LONDON RD STE 205, DULUTH, MN 55812-1788
(612) 234-4689
(612) 234-4689
Mailing address
PO BOX 51, VICTORIA, MN 55386-0051
(952) 443-4600
(952) 443-4604
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
25047
MN
Other
Enumeration date
04/17/2018
Last updated
12/10/2024
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