Individual
SHANNON MARIE JAMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW, SAC-IT
Contact information
Practice address
9730 W BLUEMOUND RD STE 11, WAUWATOSA, WI 53226-4455
(414) 336-0525
(414) 930-2986
Mailing address
918 E NORTH AVE, MILWAUKEE, WI 53212-3448
(414) 336-8651
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9133
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10004541
—
WI
Enumeration date
12/03/2017
Last updated
07/20/2020
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