Individual
SHANNON J PERKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5907
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2373015
—
OH
01
—
CP28704
MEDICARE ID
OH
Enumeration date
10/02/2006
Last updated
12/06/2011
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