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Individual

MARIE SHIELDS-PFANNENSTIEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMLP,LCMFT,LCP

Contact information

Practice address
2001 CLAFLIN RD, MANHATTAN, KS 66502-3415
(785) 587-4300
(785) 587-4321
Mailing address
423 HOUSTON STREET, PO BOX 747, MANHATTAN, KS 66505-0747
(785) 587-4300
(785) 587-4321

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
0130
KS
101YM0800X
Mental Health Counselor
236
KS
106H00000X
Marriage & Family Therapist
Primary
190
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11658852
CAQH
05
200450720A
KS
01
856677
BCBS
KS
Enumeration date
06/14/2006
Last updated
11/07/2012
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