Individual
MICHELLE SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21302 SUSSEX DRIVE STONY CREEK,, SUSSEX, VA 23882
(434) 245-1099
Mailing address
21302 SUSSEX DR, STONY CREEK, VA 23882-3751
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
PPS-570100
VA
Other
Enumeration date
09/30/2024
Last updated
09/30/2024
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