Individual
SHANNON BALDWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12216 MIDLAND TRAIL RD, ASHLAND, KY 41102-7766
(304) 638-7540
Mailing address
12216 MIDLAND TRAIL RD, ASHLAND, KY 41102-7766
(304) 638-7540
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
12/13/2024
Last updated
12/13/2024
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