Individual
SHANNON REBECCA WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 N MAIN ST, BRISTOL, CT 06010-8122
(860) 793-3500
Mailing address
79 FITZGERALD DR, EAST HARTFORD, CT 06118-2361
(860) 682-5373
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/03/2020
Last updated
08/03/2020
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