Individual
DR. SHANNON CONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
36 W 8TH ST STE 200, HOLLAND, MI 49423-2702
(616) 396-4846
(616) 396-4846
Mailing address
36 W 8TH ST STE 200, HOLLAND, MI 49423-2702
(166) 396-4846
(616) 396-4846
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6301013914
MI
103TC0700X
Clinical Psychologist
6301013914
MA
103TC0700X
Clinical Psychologist
6301013914
MI
103TC0700X
Clinical Psychologist
Primary
6301018872
MI
103TC1900X
Counseling Psychologist
6301013914
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912452
—
MI
Enumeration date
04/09/2009
Last updated
07/28/2021
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