Organization
CHRISTINE A. SHAMAN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHIRSTINE SHAMAN (MSW, LICSW)
(651) 492-0561
Entity
Organization
Contact information
Practice address
3612 WHITE ROSE AVE, BURNSVILLE, MN 55337-2402
(651) 492-0561
Mailing address
3612 WHITE ROSE AVE, BURNSVILLE, MN 55337-2402
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
15592
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811037310
—
MN
Enumeration date
05/30/2013
Last updated
03/17/2018
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