Individual
KRISTINA SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LSW
Contact information
Practice address
5638 PROFESSIONAL CIR, INDIANAPOLIS, IN 46241-5042
(888) 714-1927
(317) 247-8935
Mailing address
5638 PROFESSIONAL CIR, INDIANAPOLIS, IN 46241-5042
(888) 714-1927
(317) 247-8935
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33007163A
IN
Other
Enumeration date
10/04/2016
Last updated
10/27/2016
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