Doctor Name: | SHANNON ALJETS |
NPI Number: | 1497140149 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 149017471 |
Business Practice Address: | 337 E Ferguson Ave Wood River, IL - 620952003 |
Business Phone Number: | 6182514073 |
Business Fax Number: | 6182516246 |
Mailing Address: | 337 E Ferguson Ave, WOOD RIVER |
State: | IL |
Postal Code: | 620952003 |
Phone Number: | 6182514073 |
Fax Number: | 6182516246 |
NPI Enumeration Date: | 03/31/2015 |
NPI Last Update Date: | 03/31/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 149017471 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |