Individual
SHANNON ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5512 BIG TYLER RD, CHARLESTON, WV 25313-1304
(304) 766-9830
Mailing address
5512 BIG TYLER RD, CHARLESTON, WV 25313-1304
(304) 766-9830
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/02/2025
Last updated
05/02/2025
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