Healthcare Provider Details

I. General information

NPI: 1891487054
Provider Name (Legal Business Name): TIERRA CELESE SHANNON FINOIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TIERRA CELESE SHANNON

II. Dates (important events)

Enumeration Date: 05/24/2023
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 RESEARCH PKWY
MERIDEN CT
06450-7152
US

IV. Provider business mailing address

130 RESEARCH PKWY
MERIDEN CT
06450-7152
US

V. Phone/Fax

Practice location:
  • Phone: 203-235-1654
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17202
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number09933712
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: