Individual
SHANNON BARNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PEER SUPPORT SPECIAL
Contact information
Practice address
2628 GRAMERCY AVE, OGDEN, UT 84401-2554
(801) 603-1702
Mailing address
2628 GRAMERCY AVE, OGDEN, UT 84401-2554
(801) 603-1702
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
UT
175T00000X
Peer Specialist
—
—
Other
Enumeration date
08/29/2012
Last updated
05/25/2023
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