Provider Demographics
NPI:1306530522
Name:WARR, SHIR (NBC-HWC)
Entity type:Individual
Prefix:
First Name:SHIR
Middle Name:
Last Name:WARR
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:SHIR
Other - Middle Name:
Other - Last Name:WARR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NBC-HWC
Mailing Address - Street 1:17 OLD KINGS RD
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-2300
Mailing Address - Country:US
Mailing Address - Phone:646-298-7013
Mailing Address - Fax:
Practice Address - Street 1:17 OLD KINGS RD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-2300
Practice Address - Country:US
Practice Address - Phone:646-298-7013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTA-3715230171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach