Derico, Shannon

Derico, Shannon is an individual health care provider with primary practice located at 1100 W 6Th Ave , Gary IN 46402-1711. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Derico, Shannon can be contacted via phone (219) 885-4264.

Contact Information

Primary practice address
1100 W 6Th Ave Gary IN 46402-1711
Phone: (219) 885-4264
Fax: (219) 888-9408
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1548675739
LBN Legal business name Derico, Shannon
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2014
Last updated Jun 25th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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