Individual
MRS. SHANNON MARIE KUBALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1306 MARSHALL ST, SAINT PETER, MN 56082-4500
(507) 931-8040
Mailing address
22156 LAKE AVE, WATERVILLE, MN 56096-9317
(507) 838-5741
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
3706
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/28/2013
Last updated
03/08/2022
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