Individual
SHANNON TAYLOR BREWER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPA
Contact information
Practice address
132 JOE V. KNOX AVE, SUITE 104, MOORESVILLE, NC 28117-9203
(704) 663-6666
(704) 663-5343
Mailing address
132 JOE V. KNOX AVE, SUITE 104, MOORESVILLE, NC 28117-9203
(704) 663-6666
(704) 663-5343
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
2100
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2100
LPC LICENSE
NC
Enumeration date
11/08/2006
Last updated
07/08/2007
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