Individual
SHANNON JEAN BORTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FSA
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
01/14/2021
Last updated
03/12/2025
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