Individual
PATRICK SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3700 S RUSSELL ST STE B110, MISSOULA, MT 59801-8574
(406) 763-6611
(406) 721-5072
Mailing address
PO BOX 801, MISSOULA, MT 59806-0801
(208) 651-1226
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
BBH-LCSW-LIC-48341
MT
Other
Enumeration date
03/03/2021
Last updated
04/21/2021
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