Individual
MS. SHANNON GAMBILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4010 DUPONT CIR STE 582, LOUISVILLE, KY 40207-4888
(502) 899-5411
Mailing address
2536 RIDGEWOOD AVE, LOUISVILLE, KY 40217-1949
(502) 649-6864
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1911
KY
Other
Enumeration date
11/17/2013
Last updated
11/17/2013
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