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Individual

SHELLY DENISE CHAMPAGNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1300 ANDREA ST STE 205, BOWLING GREEN, KY 42104-3382
(270) 205-4585
(270) 936-7333
Mailing address
104 REYNOLDS RD, GLASGOW, KY 42141-1177
(270) 904-6567
(270) 904-6570

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3040
KY

Other

Enumeration date
04/09/2012
Last updated
07/21/2022
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