Individual
SHANNON CARBALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 W 4TH AVE, WILLIAMSON, WV 25661-3111
(304) 236-3517
(304) 236-3517
Mailing address
105 W 4TH AVE, WILLIAMSON, WV 25661-3111
(304) 236-3517
(304) 236-3518
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/13/2014
Last updated
10/31/2016
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