Individual
SHANNON SPELLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1919 S GRAND BLVD, SAINT LOUIS, MO 63104-1571
(314) 566-5268
Mailing address
4441 SKYRIDGE DR, SAINT LOUIS, MO 63128-2445
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2012029334
MO
Other
Enumeration date
10/29/2012
Last updated
10/29/2012
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