| Doctor Name: | THOMAS SHANN |
| NPI Number: | 1104135383 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | LSX11005 |
| Business Practice Address: | 700 Saco Rd Standish, ME - 040040038 |
| Business Phone Number: | 2076429080 |
| Business Fax Number: | |
| Mailing Address: | Po Box 38, BAR MILLS |
| State: | ME |
| Postal Code: | 040040038 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/05/2010 |
| NPI Last Update Date: | 10/05/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041S0200X |
| License Number: | LSX11005 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |