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General NPI Number Information
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NPI Number | 1134373780
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Entity Type | Individual
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Provider Name | SHANON ANN CLAUSSEN LISW
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Gender | Female
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Dates
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Enumeration Date | 11/10/2008
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Last Update Date | 04/09/2020
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Provider Practice Location Address
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Address Line | 1907 17TH AVE E
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City | OSKALOOSA
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State | IA
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Zip | 52577-3554
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Country | US
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Telephone | 641-569-8098
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Fax |
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Provider Business Mailing Address
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Address Line | 1220 S 1ST ST
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City | OSKALOOSA
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State | IA
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Zip | 52577-3915
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Country | US
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Telephone | 319-350-6718
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 00691
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License Number State | IA
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