Provider Demographics
NPI:1003372970
Name:ROBARE, SHANNON MICHELE
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:MICHELE
Last Name:ROBARE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WARE
Mailing Address - State:MA
Mailing Address - Zip Code:01082-1318
Mailing Address - Country:US
Mailing Address - Phone:413-579-7572
Mailing Address - Fax:413-277-0537
Practice Address - Street 1:78 MAIN ST
Practice Address - Street 2:
Practice Address - City:WARE
Practice Address - State:MA
Practice Address - Zip Code:01082-1318
Practice Address - Country:US
Practice Address - Phone:413-579-7572
Practice Address - Fax:413-277-0537
Is Sole Proprietor?:No
Enumeration Date:2019-02-15
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor