Most Relevant Information
Provider Data
| NPI Number: | 1003499583 |
| Provider Name: | SHANNON BLANCH |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | 110181 |
Most Important Dates
| Enumeration Date: | 05/03/2021 |
| Last Updated: | 05/03/2021 |
Provider Practice Location
1 LOIS PL
KATONAH
NY
105363617
Practice Location Phone/Fax
| Phone: | 7192912872 |
| Fax: |
Provider Mailing Location
1 LOIS PL
KATONAH
NY
105363617
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |