Individual
SHANNON BOTELHO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
389 COUNTY ST, NEW BEDFORD, MA 02740-4995
(508) 997-1570
Mailing address
9 WILDROSE LN, ACUSHNET, MA 02743-1895
(508) 997-1570
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
05/22/2012
Last updated
05/22/2012
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