Individual
MRS. SHANNON ROSE INDIEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2006 1ST AVE, DODGE CITY, KS 67801-2623
(620) 371-6548
Mailing address
PO BOX 88, SPEARVILLE, KS 67876-0088
(620) 385-0427
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
11762
KS
Other
Enumeration date
07/10/2020
Last updated
07/10/2020
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