Individual
MS. PEGGY N. SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CAC III
Contact information
Practice address
4851 INDEPENDENCE ST, WHEAT RIDGE, CO 80033-6715
(303) 425-0300
Mailing address
4851 INDEPENDENCE ST, SUITE 200, WHEAT RIDGE, CO 80033-6715
(303) 425-0300
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6870
CO
Other
Enumeration date
02/10/2011
Last updated
02/10/2011
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