Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 24314 | MD |
NPI | 1003465568 |
---|---|
Provider Name | Shannon D Thomas |
First Address | Salisbury, MD 21804-2904 |
Second Address | Cambridge, MD 21613-1834 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2019 |
Last Update Date | 08/09/2019 |