Organization
ICAN CONSULT & COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TABATHA SHANKLE (OWNER)
(573) 262-8515
Entity
Organization
Contact information
Practice address
505 N MAIN ST, CHARLESTON, MO 63834-1030
(573) 262-8515
Mailing address
505 N MAIN ST, CHARLESTON, MO 63834-1030
(573) 262-8515
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/24/2021
Last updated
02/24/2021
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