# MISS SHANNA CULLEN-CARROLL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1730211715
- **Gender:** F
- **Credential:** MFT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | 49429 | CA | — |
| 106H00000X | Marriage & Family Therapist | T-CTL0212371 | NM | Yes |

## Other

- **Enumeration date:** 03/12/2007
- **Last updated:** 10/23/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 330489658 | TAX ID \# | CA |