Individual
MICHELLE SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
915 OLENTANGY RIVER RD FL 4, COLUMBUS, OH 43212-3153
(614) 366-1552
Mailing address
DEPT 781629, PO BOX 78000, DETROIT, MI 48278-1629
(614) 355-2103
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A.01940
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1473276
—
OH
Enumeration date
03/02/2016
Last updated
07/29/2019
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