Individual
SHANNON BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7310 RITCHIE HWY STE 100, GLEN BURNIE, MD 21061-3170
(443) 704-1082
Mailing address
7310 RITCHIE HWY STE 100, GLEN BURNIE, MD 21061-3170
(443) 704-1082
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LGP11625
MD
Other
Enumeration date
10/11/2021
Last updated
10/13/2021
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