Individual
MR. DAVID W. SHANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.C.S.W. (ILLINOIS)
Contact information
Practice address
512 S FREMONT ST, ORCHARD CORNERS 150-160, SHENANDOAH, IA 51601-1508
(712) 246-0092
Mailing address
512 S FREMONT ST, ORCHARD CORNERS 150-160, SHENANDOAH, IA 51601-1508
(712) 246-0092
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.002871
IL
Other
Enumeration date
04/08/2009
Last updated
04/08/2009
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