Individual
MS. SUSAN KAY SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDP
Contact information
Practice address
3629 S D ST, TACOMA, WA 98418-6813
(253) 798-6576
Mailing address
3629 S D ST, TACOMA, WA 98418-6813
(253) 798-6576
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/02/2019
Last updated
09/24/2019
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