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Individual
MS. KATHLEEN NOELLE SHANNON
Active
Individual
MS. KATHLEEN NOELLE SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., .M.F.C.
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C.A.D.A.C. 1591
AZ
101YM0800X
Mental Health Counselor
L.P.C. 2093
AZ
106H00000X
Marriage & Family Therapist
Primary
49712
CA
Other
Enumeration date
12/22/2006
Last updated
04/01/2011
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