Provider Information for 1902536428
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SHANNON M DENMAN LCSW
Sex: Female
NPI: 1902536428
Last Updated: 2025-03-12
Certification Date: 2025-03-12
Certification Date: 2025-03-12
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1902536428 | ||||||||
| Enumeration Date | 2022-06-16 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2401 W MAIN ST MARION, IL 62959-1188 United States Phone: 618-997-5311 | Fax:618-985-4635 | ||||||||
| Primary Practice Address | 2401 W MAIN ST MARION, IL 62959-1188 United States Phone: 618-997-5311 | Fax: | ||||||||
| Secondary Practice Address(es) | 405 W JACKSON ST 201 S 14TH ST 2 S HOSPITAL DR | ||||||||
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