Individual
SHANNON BARRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8 BOURNE ST, CLINTON, MA 01510-2204
(508) 254-1393
Mailing address
8 BOURNE ST, CLINTON, MA 01510-2204
(508) 254-1393
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
MA
103TS0200X
School Psychologist
Primary
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265E
—
MA
Enumeration date
08/14/2015
Last updated
04/24/2024
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