Individual
SHANON E HEID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1095 MIDWAY RD, MENASHA, WI 54952-1115
(920) 740-6526
Mailing address
1095 MIDWAY RD, MENASHA, WI 54952-1115
(920) 740-6526
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
11220
WI
101YP2500X
Professional Counselor
Primary
11220
WI
Other
Enumeration date
12/09/2024
Last updated
01/02/2025
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