Individual
SHANNON DENISE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
761 3RD ST, NEW MARTINSVILLE, WV 26155-1403
(304) 455-3035
Mailing address
230 INDIAN CREEK RD, ALMA, WV 26320-7015
(304) 758-2032
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2392
WV
Other
Enumeration date
09/24/2021
Last updated
09/24/2021
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