Individual
SHANNON YANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSE LPC CADCD
Contact information
Practice address
1810 APPLETON ROAD, MENASHA, WI 54952
(920) 739-4226
(920) 739-7639
Mailing address
1810 APPLETON ROAD, MENASHA, WI 54952
(920) 739-4226
(920) 739-7639
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
5264
WI
101YP2500X
Professional Counselor
Primary
3518125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41008200
—
WI
Enumeration date
01/26/2007
Last updated
06/04/2009
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