Individual
SHANNON L GILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3860 MONROE RD, DE PERE, WI 54115-8399
(920) 496-4700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
6801102121
MI
1041C0700X
Clinical Social Worker
Primary
9652-123
WI
Other
Enumeration date
02/05/2018
Last updated
02/10/2023
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