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Shannon Dee Wassam
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Smithton, Missouri
NPI 1356465033

Shannon Dee Wassam is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Smithton, MO. Shannon Dee Wassam practices in Smithton, MO. The NPI Number for Shannon Dee Wassam is 1356465033 and holds a License No. (Missouri).

The current practice location address for Shannon Dee Wassam is 308 E Smith St, Smithton, MO and can be reached out via phone at 660-343-3681 and via fax at 660-343-5871.

Location: 308 E Smith St, Smithton, MO, 65350-0513
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1356465033
Provider Name
Shannon Dee Wassam
Credential
Provider Entity Type
Individual
Gender
Female
Address
308 E Smith St, Smithton, MO, 65350-0513
Phone Number
660-343-3681
Fax Number
660-343-5871
Provider Enumeration Date
03/19/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
308 E Smith St
City
Smithton
State
Missouri
Zip
65350-1079
Phone Number
660-343-3681
Fax Number
660-343-5871
person
Provider Business Mailing Address Details
Address
308 E Smith St
City
Smithton
State
Missouri
Zip
65350-1079
Phone Number
660-343-3681
Fax Number
660-343-5871
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
()
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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