Individual
ANDREA SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 9TH ST, BECKLEY, WV 25801-3956
(681) 368-4845
Mailing address
111 9TH ST, BECKLEY, WV 25801-3956
(681) 368-4845
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
10/15/2020
Last updated
10/15/2020
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