Individual
SHIVON MASSENBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCC
Contact information
Practice address
2138 PRIEST BRIDGE CT STE 1, CROFTON, MD 21114-2463
(443) 351-8033
Mailing address
PO BOX 1425, BOWIE, MD 20717-1425
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/02/2017
Last updated
06/02/2024
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