Individual
SHANNON L GNACINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
135 E 38TH ST, ERIE, PA 16504-1559
(814) 860-2472
(814) 868-6247
Mailing address
2704 MELROSE AVE, ERIE, PA 16508-1437
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW124870
PA
Other
Enumeration date
08/14/2012
Last updated
08/14/2012
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