Provider Demographics
NPI:1578884821
Name:BURTON, SHANNON MARIE (HN)
Entity Type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:MARIE
Last Name:BURTON
Suffix:
Gender:F
Credentials:HN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 EAST BROOK RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-2075
Mailing Address - Country:US
Mailing Address - Phone:781-302-4893
Mailing Address - Fax:781-234-1183
Practice Address - Street 1:20 EASTBROOK RD
Practice Address - Street 2:SUITE 201
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-2075
Practice Address - Country:US
Practice Address - Phone:781-302-4893
Practice Address - Fax:781-234-1183
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator