Individual
DR. CASEY ROSE SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
189 ADELPHI AVE, HARRISON, NY 10528-2617
(516) 220-6779
Mailing address
189 ADELPHI AVE, HARRISON, NY 10528-2617
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
020534
NY
Other
Enumeration date
11/17/2017
Last updated
11/17/2017
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