Provider Demographics
NPI:1992288856
Name:SHELMERDINE, ANNE KAMIN
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:KAMIN
Last Name:SHELMERDINE
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 1:22 NIANTIC RD
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-2962
Mailing Address - Country:US
Mailing Address - Phone:781-254-6796
Mailing Address - Fax:
Practice Address - Street 1:NORTH ATTLEBORO HIGH SCHOOL
Practice Address - Street 2:1 WILSON WHITTEY WAY
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760
Practice Address - Country:US
Practice Address - Phone:508-643-2115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1047931041S0200X
1047931041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool