Individual
SHANNON SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
540 LITCHFIELD ST, TORRINGTON, CT 06790-6679
(860) 496-6359
Mailing address
112 VERBANK RD, MILLBROOK, NY 12545-6008
(845) 554-7066
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
02/07/2012
Last updated
11/18/2014
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