Individual
EVA MARIA SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
599 CANAL ST, LAWRENCE, MA 01840-1244
(508) 269-5100
Mailing address
12 HESPERUS CIR, GLOUCESTER, MA 01930-5205
(508) 269-5100
(978) 686-1281
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6410
MA
Other
Enumeration date
01/02/2007
Last updated
07/08/2007
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