Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHANNON DEE WASSAM
Active Sole ProprietorSHANNON DEE WASSAM is a Emotionally Disturbed Children Residential Treatment healthcare provider located in SMITHTON, Missouri. NPI 1356465033 is currently active in the NPPES registry. Verify at CMS.
Emotionally Disturbed Children Residential Treatment · SMITHTON, MO
Registration Details
- NPI Number
- 1356465033
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 19, 2007 (19.42804172558 yrs)
- Last Updated
- Oct 7, 2014
- Sole Proprietor
- Yes
Practice Information
- Address
-
308 E SMITH STSMITHTON, MO, 653501079Browse MO providers · Browse ZIP 65350
- Phone
- 6603433681
- Fax
- 6603435871
- Primary Specialty
-
Emotionally Disturbed Children Residential Treatment
320900000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.