Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | MI |
NPI | 1003457938 |
---|---|
Provider Name | Shannen Majhor |
First Address | Houghton, MI 49931-2475 |
Second Address | Houghton, MI 49931-2475 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2019 |
Last Update Date | 02/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6801105610 | LLMSW (01) | MI |