Shannon Moore

NPI #1750758322 in Randolph, Massachusetts

Provider Information

NPI Number: 1750758322
Entity Type: Individual
Name: Shannon Moore
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker - Clinical
Enumeration Date: Aug 30, 2015
Last Updated: Aug 30, 2015

Practice Location

Address: 42 DIAUTO DR
City: Randolph
State: Massachusetts
ZIP Code: 02368-4510
Phone: (781) 885-7252

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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