Doctor Name: | DONNA SHANAHAN |
NPI Number: | 1790907020 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 67 Captain Cushman Rd Morrill, ME - 049525035 |
Business Phone Number: | 2073423655 |
Business Fax Number: | |
Mailing Address: | 67 Captain Cushman Rd, MORRILL |
State: | ME |
Postal Code: | 049525035 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/03/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TR0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Rehabilitation |
Taxonomy Definition: |