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Individual
SHANNON LAUREN THOMASON
Active
Individual
SHANNON LAUREN THOMASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, SUDCC IV
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
68562
CA
1041C0700X
Clinical Social Worker
Primary
88355
CA
390200000X
Student in an Organized Health Care Education/Training Program
C1103161045
CA
Other
Enumeration date
09/04/2013
Last updated
05/22/2019
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