Individual
DR. THEODORE PAUL SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, MS
Contact information
Practice address
1035 PROPRIETORS RD, WORTHINGTON, OH 43085-3230
(614) 785-1115
(614) 785-0095
Mailing address
1035 PROPRIETORS RD, WORTHINGTON, OH 43085-3230
(614) 785-1115
(614) 785-0095
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C 0700153
OH
Other
Enumeration date
08/23/2011
Last updated
08/23/2011
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