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Individual
MR. SHANTAY MINES
Active
Individual
MR. SHANTAY MINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.S, LMFT
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
124011
CA
106H00000X
Marriage & Family Therapist
IMT2104
FL
106H00000X
Marriage & Family Therapist
Primary
LMFTA #9001A
NC
Other
Enumeration date
05/23/2013
Last updated
08/24/2021
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