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Individual

SHAWN CHANNELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
76 SUMMER ST STE 115, FITCHBURG, MA 01420-5705
(978) 257-4958
Mailing address
144 MAIN ST, WESTMINSTER, MA 01473-1542
(978) 257-4958

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
18566
CA
103TF0200X
Forensic Psychologist
Primary
9403
MA

Other

Enumeration date
04/27/2018
Last updated
04/27/2018
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