Individual
SHANNON WISCHUSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
261 BROOME ST APT 2H, NEW YORK, NY 10002-4507
(908) 347-7055
Mailing address
261 BROOME ST APT 2H, NEW YORK, NY 10002-4507
(908) 347-7055
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
01/27/2020
Last updated
01/27/2020
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