| Doctor Name: | SHANNON MARIE REBIEJO |
| NPI Number: | 1558723650 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CSW INTERN |
| License Number: | 5210-S |
| Business Practice Address: | 1675 Avenue F Ely, NV - 893013500 |
| Business Phone Number: | 7752891671 |
| Business Fax Number: | 7752891699 |
| Mailing Address: | 1671 Ave F, ELY |
| State: | NV |
| Postal Code: | 893011221 |
| Phone Number: | 7752891671 |
| Fax Number: | 7752891699 |
| NPI Enumeration Date: | 03/28/2016 |
| NPI Last Update Date: | 03/28/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 5210-S |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NV |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |