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Individual
KRISTY SHANKS
Active
Individual
KRISTY SHANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
84091
CA
104100000X
Social Worker
Primary
103353
CA
104100000X
Social Worker
84091
CA
Other
Enumeration date
07/26/2016
Last updated
11/05/2021
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