Individual
SHANNON CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1338 WESTEN ST, BOWLING GREEN, KY 42104-3365
(270) 392-5531
Mailing address
104 PEDIGO ST, GLASGOW, KY 42141-1439
(270) 392-5531
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/19/2016
Last updated
10/19/2016
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