Individual
DR. SHANNON WALSDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, MSW, LCSW
Contact information
Practice address
4005 AZALEA CT, MANDEVILLE, LA 70448-7044
(985) 373-8609
Mailing address
4005 AZALEA CT, MANDEVILLE, LA 70448-7044
(985) 373-8609
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11202
LA
Other
Enumeration date
02/11/2015
Last updated
02/11/2015
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