Individual
SHANNON MARIE OLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
76 ASHWOOD DR, TIFFIN, OH 44883-1908
(419) 448-9440
Mailing address
1925 HAYES AVE, SANDUSKY, OH 44870-4737
(419) 557-5177
(419) 557-5179
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
333656
OH
Other
Enumeration date
04/19/2012
Last updated
04/19/2012
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