Individual
SHANNON S. WYSINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
5360 MOCERI LN, GRAND BLANC, MI 48439-4365
(810) 240-1849
Mailing address
5360 MOCERI LANE, GRAND BLANC, MI 48439-4365
(810) 240-1849
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401011056
MI
101YM0800X
Mental Health Counselor
6401011056
MI
Other
Enumeration date
10/21/2008
Last updated
10/04/2018
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